There’s U.S. News & World Report‘s “Best Hospitals.” The Leapfrog Group releases its Hospital Safety Grade. And ProPublica has the Surgeon Scorecard.
All these provider rating systems … but are they worthwhile and accurate? An NEJM Catalyst article, written by Dr. Karen Joynt of the Harvard T.H. Chan School of Public Health, takes a closer look.
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For those in the “yea” camp, provider rating systems can undoubtedly be beneficial because of exactly what they do: point out the hospitals that provide both excellent and subpar care.
On one hand, it’s key to note which health systems and doctors are surpassing their peers. By making this information public, patients can better select the best and safest hospital to go to.
It’s also crucial to know which physicians are providing detrimental care, as well as which hospitals are failing to meet basic standards for providing care.
Overall, “there is a role for a systematic, user-friendly way to provide patients with information (ideally based on data, not on physician anecdotes, which are subject to bias) about where to seek care,” the article notes.
Looking at the “nay” camp, Joynt also outlines reasons why provider rating systems shouldn’t be praised too highly. “[O]ur current rating methodologies are so woefully inadequate that not only do they fail to accurately identify high- and low-quality providers, but they may also falsely accuse good providers of being bad ones,” according to the article.
The number one problem with provider rating systems, Joynt claims, is “inadequate risk adjustment.” With potentially skewed data, one hospital could appear to have high mortality rates, while in actuality it’s helping the sickest patients. Additionally, a rating could show a physician as average, when he or she is actually caring for low numbers of patients and is probably substandard.
After equally weighing both sides of the argument, Joynt concludes that provider rating systems do have value.
“We should convey information quickly when we think a provider is unsafe, while allowing providers labeled as such to have an appeals mechanism,” she claims in the article. “And we should identify high performers, learn from them, and spread their best practices.”
Still, Joynt advocates for being as accurate as possible and refraining from incorrectly reporting information. Moreover, she stresses the need to bring innovative thinking to performance assessment.
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