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Archive for the ‘CMS, HHS’ Category

Healthcare 3R’s Bring Pain and Gain

• Posted May 23rd 2008
• Comments (0)
• by Janice

 Arguably the most powerful and actionable of all consumer health information, ratings, rankings ad recommendations (the 3R’s), present both opportunities and minefields, as the Massachusetts Group Insurance Commission (GIC) found out this week when a lawsuit was filed against them by the Massachusetts Medical Society (MMS).   

GIC ranks physicians using cost and quality measures, and its rankings are used for  cost containment; patients have to pay higher copayments for doctors who rank in the lower tiers.  MMS, which has more than 20,000 physicians and student members, alleges that GIC’s system, called Clinical Performance Improvement Initiative (CPI), uses “inaccurate, unreliable and invalid tools and data”.  In particular, the complaint cites miscoding of procedures and inaccurate assignment of patients to physicians who were not responsible for their care. 

A different ratings approach is practiced by the department of Health and Human Services’ (HHS). Its CAHPS program  centers its rankings on patient satisfaction measures.   HHS was also in the news this week with a near-full-page ad in local papers in all 50 states promoting the use of the Hospital Compare site (http://www.hospitalcompare.hhs.gov/). As reported by AP, “the ads reflect an emphasis by the Bush administration to increase transparency in the health care system. Officials say greater public disclosure of costs and quality will drive providers to improve on both fronts.”

Currently, hospitals are penalized with a reduction in their reimbursement rates from CMS if they do not participate in the CAHPS program.  It is expected that HHS will continue down the path of pay-for-performance (P4P) as the CAHPS program develops.  

The 3R’s are shaping up to be a lively and controversial business, and Health Content Advisors and our parent company, InfoCommerce Group, will continue to monitor closely those information products that offer ratings, rankings, and recommendations, and you can look for them to continue to play a prominent role in this year’s Health Content08 conference.

 

Consumer-Driven Health Care Drives Demand for Ratings

• Posted May 8th 2008
• Comment (1)
• by Janice

The proliferation of doctor ratings sites continues unabated and is likely to continue. The two main drivers of growth are both related to the consumer-directed healthcare movement: 1) the demand for information about healthcare providers from consumers/patients and 2) the focus on measuring quality and satisfaction in healthcare. 

The recent traffic records achieved by Castle Connolly, the publishers of the “Top Doctor” guides, during their promotion of “Long Island’s Top Doctors” on Newsday.com demonstrates the strong demand for the data.  Searches for doctors profiles in the database (accessible via Newsday) resulted in over 1.2 million profile views on just one day.   

On the quality and satisfaction front, the Centers for Medicare & Medicaid Services (CMS), a division of HHS, has led efforts to compile standardized ratings of healthcare providers and practitioners through their Consumers Assessment of Health Providers and Systems (CAHPS) program.  CAHPS originally measured satisfaction with health plans, but has branched out into measuring patient satisfaction with hospitals, and has begun  measuring satisfaction with physicians through the CAHPS Clinician and Group survey.  The availability of the CAHPS Clinician survey benchmark data (beginning Spring 2009) may spur even more entrants into the doctor ratings business, but it should also raise the bar for the quality of the ratings sites that survive in this competitive field.