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When Hospitals Sponsor Lifesaving Tests That Aren't
Tweet Share on Facebook May 14, 2013 CommentFor the last year and a half, residents of the Washington, D.C., metro area have been blizzarded with direct mail and print and media ads promoting a $139 package of "five life-saving tests for heart disease and stroke." The tests are targeted at consumers who are worried about their risk of sudden death or disability. To get tested, they need only to show up at a given location on a given day and climb into a specially equipped van operated by a medical-screening company called HealthFair. Those with worrisome findings need not look far for a referral for follow-up testing or more sophisticated care — the buses carry the reassuring logo of Inova Health System, one of the region's largest hospital networks, a system that prides itself on providing high quality medical care.
Consumers also must be prepared to pay; the tests are not usually covered by insurance. And there's good reason for this. In most cases, the tests aren't necessary, and may expose patients to additional risks through follow-up tests and procedures, according to a story reported by Kaiser Health News and published in Tuesday's Washington Post. The story notes that the influential U.S. Preventive Services Task Force, an independent government panel that evaluates the evidence and rules on which tests have value and which do not, as well as several medical specialty associations and other groups that craft medical guidelines, reject the use of most of the tests on people who lack symptoms or significant risk factors. The evidence is strong, say these organizations, that the tests' benefits fail to outweigh their risks, including false positives (results that suggest nonexistent problems) that generate followup procedures and unnecessary operations drive up the cost of care, generate needless anxiety, and put patients at risk.
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Hospitals Charge a Lot. What Else Is New?
Tweet Share on Facebook May 8, 2013 CommentToday the Centers for Medicare & Medicaid Services released new data that for the first time, according to Health and Human Services Secretary Kathleen Sebelius, "gives consumers information on what hospitals charge." It laid out what every hospital in the U.S. bills CMS for the 100 most common Medicare procedures and conditions, and how much the hospital is reimbursed.
The big news, Sebelius informed reporters on a call-in news conference, was that the amounts hospitals bill Medicare charge for the same procedure "vary dramatically in ways that can't be easily explained."
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Dates Set for Best Hospitals and Best Children's Hospitals
Tweet Share on Facebook April 30, 2013 CommentIt's getting close to that time of year. U.S. News has settled on the dates when we will notify hospitals that have earned national, regional or state ranking for 2013-14. We will inform ranked hospitals by embargoed email.
Notification will follow this schedule:
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TEDMED, ZDoggMD and the State of Healthcare
Tweet Share on Facebook April 22, 2013 CommentThe question is not how Zubin Damania, M.D., morphed into ZDoggMD, but why — and what one physician's transformation into a comic rapper and medical innovator says about U.S. healthcare.
Damania — whose ZDoggMD credits include "Diarrhea: The Musical" and "Manhood in the Mirror" (the latter a tribute to testicular self-examination performed to a popular Michael Jackson tune) — told a crowd of 1,800 at TEDMED in Washington, D.C., last week that his humor is grounded in deep frustration over a health system that, he says, grinds away at doctors' ability to truly care for patients. "It's a story that the public doesn't understand," Damania says. "We're a victim of the system as much as anyone else."
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Best Hospitals Reputational Survey Closes
Tweet Share on Facebook April 17, 2013 CommentMore than 1,050 physicians took time this year to respond to our annual Best Hospitals survey by telling us which hospitals they would recommend in their specialty for the most challenging patients. Their nominations will play a role in the 2013-14 Best Hospitals rankings, which are scheduled for release in mid-July. The late Bernadine Healy, our former health editor and prior to that a noted cardiologist and director of the National Institutes of Health, often said she considered the reputational survey an important form of peer review.
For Best Hospitals, we select a random sample of 200 board-certified specialists in each of 16 adult specialties from cancer to urology. We then ask them to name up to 10 hospitals they consider the best for inpatients who demand an especially high level of expertise because of their medical condition or the procedure required, and we instruct the doctors to ignore cost and location. RTI International, a major consulting organization in Triangle, N.C., that assembles the Best Hospitals and Best Children's Hospitals rankings for U.S. News, directs the survey and tabulates the results.
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What Is Your Hospital Called?
Tweet Share on Facebook April 17, 2013 CommentWe recognize that in today's choppy healthcare seas, those who run hospitals are on the hunt for ever-better ways to present and promote themselves. One approach is to change the hospital's name. So each year, through our Best Hospitals and Best Children's Hospitals contractor, U.S. News reaches out to contacts at thousands of hospitals and healthcare systems to ask whether they want us to call their centers something different than the name U.S. News used the year before.
We can't always reach them. Although RTI International, our contractor, has both a primary and secondary contact, with emails and phone numbers, sometimes both individuals have moved on, or the contact information is incorrect, or the invitation to submit a new name is overlooked or misdirected to the spam folder.
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Best Children's Hospitals: Doctor Survey Ends
Tweet Share on Facebook March 28, 2013 CommentThe Best Children's Hospitals rankings, like the Best Hospitals rankings of adult centers, factor in specialists' opinions concerning the best sources of care for the sickest patients. The reputational survey that will supply these doctors' recommendations for the 2013-14 pediatric rankings, which are scheduled to appear in mid-June, has now closed. We're delighted — and grateful — to report that more than 52 percent of the surveyed physicians responded. This is at a time when doctors are busier than ever and might impatiently brush off efforts to get their views, yet the response rate was within less than two percentage points of the previous year's survey.
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Are There Too Many Hospital Rankings?
Tweet Share on Facebook March 20, 2013 CommentWhere can you go to find one list that names the "best cars"? The answer, of course, is obvious. There isn't one. What does "best" mean — best for short commutes or for interstate cruising? Best for a 16-year-old who just got her license or for a middle-aged male looking for fun? Best for reliability or for fuel economy?
Just as with cars, no single set of ratings or evaluations can adequately define hospital quality. A hospital that does a fine job delivering babies or performing routine bypass surgery may not be where to look for delicate lifesaving cancer surgery or state-of-the-art care for cystic fibrosis. Some ratings, like Leapfrog's, focus largely on safety; others, like the federal government's Hospital Compare, on compliance with generally accepted care standards. And still others, like HealthGrades, judge hospitals in individual conditions and procedures. A Kaiser Health News story raises the question, not for the first time, of whether the public is confused rather than guided by this proliferation of hospital rankings, ratings and reports.
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Do Hospital 'Likes' Translate to Quality?
Tweet Share on Facebook March 14, 2013 CommentCan it be that the number of "likes" on a hospital's Facebook page has something to do with the quality of the hospital? Could be, say researchers at the Healthcare Innovation and Techology Lab, a New York think tank.
They state in a recently published analysis that they found a "strong negative, statistically significant relationship" between the number of "likes" on the Facebook pages of 40 New York-area hospitals and the hospitals' 30-day heart attack death rates. The higher the number of likes, in other words, the greater the chance that a hospital had a lower mortality rate. "These findings have implications for researchers and hospitals looking for a quick and widely available measure" of hospital quality, the team stated in their study, which was published online in the "American Journal of Medical Quality."
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Best Children's Hospitals 2013-14: Progress Report
Tweet Share on Facebook March 12, 2013 CommentTo produce the medical data for the 2012-13 Best Children's Hospitals rankings, which are currently posted, U.S. News contractor RTI International sent a clinical survey to 178 pediatric centers. Ninety-seven centers, or 54.5 percent, completed the lengthy, detailed questionnaire. The allotted time for submitting the 2013-14 survey has now ended, and we are pleased to report that 109 of the 179 hospitals that received the survey responded, a jump to 60.9 percent.
The 11-part clinical survey takes the form of a general section and 10 individual specialty sections, from cancer to urology. Hospitals must complete the general section and at least one specialty section to be evaluated, because the information yielded by the clinical survey provides most of the grist for the Best Children's Hospitals rankings. A small part of each hospital's score is based on a reputational survey of 1,500 pediatric specialists, also conducted by RTI on behalf of U.S. News. That survey is still in the field, so we don't yet have final numbers on the response rate.
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