Quality of Care


Covered California Among First Exchanges to Post Customer Quality Ratings

The ratings are on a 4-star rating with 4 being high. (screenshot from Covered California)

Plans are rated with 1-4 stars, with 4 being high. (screenshot from Covered California)

Anna Gorman, Kaiser Health News

Californians shopping for insurance policies through the state’s online marketplace can now compare plans based on customer quality ratings as well as cost.

Covered California assigned star ratings to the health plans based on member survey responses. Each health insurance plan is compared with results of other plans across the western United States. The surveys were taken before the insurance marketplace opened, so they only compare plans that had a track record beforehand.

The ratings cover such topics as access to medical appointments, customer service and the quality of medical care and are from the federal government’s Consumer Assessment of Healthcare Providers and Systems.

Consumers can purchase individual policies through the exchange and many are eligible for financial help paying their premiums. For coverage this year, they have until March 31 to enroll. Continue reading

Medicare Quality Ratings: No Effect on Patient Deaths

By Jordan Rau, Kaiser Health News

Medicare’s seven-year effort to spur quality improvements in hospital care by publishing key performance metrics on its Hospital Compare website has not resulted in fewer patient deaths, according to a new Health Affairs study.

In 2005, Hospital Compare started rating more than 3,000 hospitals on how well they adhere to basic guidelines for clinical care, such as giving flu vaccinations to pneumonia patients. Over time, Hospital Compare has added the results of patient experience scores, readmission and mortality rates, and, most recently, rates of complications and other patient safety mishaps.

There’s been little evidence that consumers use the site in choosing hospitals. Still, health policy experts have hoped poor performing hospitals would nonetheless be embarrassed enough by their public scores to make changes. Indeed, scores on many of the measures have improved over time.

But the new study questions whether any of this was actually leading to better outcomes for patients, such as their chance of survival in the month after they were discharged. The study found that at the time Hospital Compare was launched, mortality rates for patients with three common ailments — heart attacks, heart failure and pneumonia — were already decreasing. After those trends were taken into account, Hospital Compare was found to have no effect on the 30-day survival rate of heart attack and pneumonia patients, according to the study.

There was only a “modest” reduction in death rates for heart failure, and that could have been due to something other than Hospital Compare, the study said. “Hospital Compare did not result in patients’ shifting toward high-quality hospitals, and led to little or no reduction in mortality rates within hospitals beyond existing trends,” the paper concludes.

Starting in October 2013, hospitals will have an added reason to improve their mortality rates. As part of the health law’s value-based purchasing programmortality rates will added to the factors Medicare uses in determining how much to reimburse hospitals.