HEALTH CARE DECISIONS BASED ON STAR RATINGS
Every day in the health care industry, consumers increasingly make decisions on which providers to see, what treatment options to pursue and what price to pay for everything from routine care and diagnostic tests to the most complex of medical procedures.
We are all moving toward a more consumer-driven health care world. But unlike other retail and consumer markets, the average health care consumer has relatively little information with which to evaluate their options.
Are we also moving toward a place where we choose doctors or hospitals based on how many stars they have? Americans choosing their health care like a car or automobile, based on online reviews and rankings from third-party quality scores, raises the question of whether this is an appropriate and meaningful way to make health care decisions.
This evolution was highlighted in a recent New York Times’ report on the North Carolina Children’s Hospital and its pediatric heart surgery program. The story focused on the hospital’s mortality rate that is higher than other leading institutions performing the same work and almost twice the national average. The hospital announced on June 17 that it was suspending the program with no stated date to resume the program.
An important component of the story was the Society of Thoracic Surgeons (STS) star ratings of pediatric heart surgery programs throughout the country. The STS system is a voluntary, self-reporting quality data initiative intended to provide information that will assist physicians and consumers in evaluating a provider’s quality measures. The STS website itself says, “… The Society of Thoracic Surgeons believes that the public has a right to know the quality of surgical outcomes.”
Over the past two decades watching the rise of consumer activism in health care and internet-based ratings systems, my experience is that even the best organizations providing health care ratings and quality — Healthgrades, WebMD and J.D. Power and Associates — have diligently tried to provide credible, useful information. Yet, to date, none of them or any other private or government entity has emerged as the one, single trusted source of health care consumer information like a “Consumer Report” is used in buying a car or other consumer product.
Perhaps the bigger challenge is consumer education and whether consumers are even aware of the health care quality data that is available online today — and how to use it most appropriately. Rating health care providers by the number of stars they have may be overly simplistic, but it’s also a means to an end, not the end itself.
A single, overarching star ranking will be difficult in health care. The variety and complexity of health care services cannot be boiled down to a single star. Being good or top-ranked in one service or program is not 100% transferrable to another service or program. The complexities of ranking health care is that even within a given program or service, the quality of individual physicians, nurses, therapists and other caregivers can vary greatly.
Finally, since virtually all insurance plans tell us that the goal is to make patients, and consumers in general, more accountable for their health care decisions, the trend is obvious. If that is the case, then the industry has to provide consumers the tools and resources to make better decisions. Whether it is clinical care, customer service or pricing, the move toward more and better transparency in health care is a positive trend for all who work in and rely on the health care system.
And that is all of us.
Daniel Fell is a Chattanooga-based national marketing consultant with more than 30 years of experience working in the health care industry.