Saturday, June 23, 2018
Health

New hospital ratings rankle Tampa Bay area hospitals

No hospitals in the Tampa Bay region received the top score of five stars in the federal government's first-ever overall hospital quality rating this week.

Three received the next highest designation: Florida Hospital Wesley Chapel, Mease Countryside Hospital and Mease Dunedin Hospital.

The lowest-performing hospitals were South Bay Hospital in Sun City Center, Florida Hospital Tampa and Bayfront Health Brooksville. Each received one star.

All other facilities in the region received a two- or three-star rating.

The new ratings of 3,617 hospitals on a one- to five-star scale roiled many hospital officials — locally and nationally. The hospital industry argues the ratings make places that treat the toughest cases look bad and had been pressing the Obama administration and Congress to block their release.

But Medicare held firm, saying that consumers need a simple way to objectively gauge quality. Medicare does factor in the health of patients when comparing hospitals, though not as much as some hospitals would like.

In a statement, leaders at the two-star rated Tampa General Hospital said they support the goals of "health groups formulating quality measures." But they raised concerns about the new federal system, saying it "oversimplifies the complexities of health care in a way that is not useful to consumers."

Tampa General officials also characterized the ratings as "badly skewed in (their) evaluation of America's teaching and safety-net hospitals."

Florida Hospital, which had some of the state's best and worst rated facilities, added that the ratings "fail to adjust for patient circumstances that influence health and health care outcomes that are outside a hospital's control."

Nationwide, just 102 hospitals received the top rating of five stars, and few were those considered as the nation's best by private ratings sources such as U.S. News & World Report or viewed as the most elite within the medical profession.

Medicare awarded five stars to relatively obscure hospitals and at least 40 hospitals that specialize in just a few types of surgery, such as knee replacements. There were more five-star hospitals in Lincoln, Neb., and La Jolla, Calif., than in New York City or Boston. Memorial Hermann Hospital System in Houston and Mayo Clinic in Rochester, Minn., were two of the nationally known hospitals getting five stars.

Medicare awarded the lowest rating of one star to 129 hospitals. Five hospitals in Washington, D.C., received just one star, including George Washington University Hospital and MedStar Georgetown University Hospital, both of which teach medical residents.

Federal health officials based the star ratings on 64 individual measures that are published on its Hospital Compare website, including death and infection rates and patient reviews. Some measures are based on data only from Medicare beneficiaries; others are based on data from hospitals' general patient population.

Medicare noted that specialized and "cutting-edge care," such as the latest techniques to battle cancer, are not reflected in the ratings.

Dr. Elizabeth Mort, chief quality officer at Massachusetts General Hospital in Boston — which Medicare awarded four stars — said Medicare should have factored in attributes of each hospital, such as what kind of services it offered and how the nursing profession assesses the staff quality.

Steven Lipstein, the president of BJC HealthCare in St. Louis, which runs Barnes-Jewish Hospital and 13 others, said that Medicare awarded between two and four stars to the system's hospitals, even though they all "employ the same standards, the same methodology, the same clinical guidelines." The major difference, he said, was the comparative affluence of the patients each served, with poorer scoring hospitals located in lower income areas.

"The stars tell you more about the socio-demographics of the population being served than the quality of the hospital," he said in an interview.

A preliminary analysis Medicare released last week found hospitals that treated large numbers of low-income patients tended to do worse. Medicare does not consider patients' social and financial situations in rating hospitals.

A sizable proportion of the nation's major academic medical centers, which train doctors, scored poorly, according to a Kaiser Health News analysis. Out of 288 hospitals that teach significant numbers of residents, six in 10 received below-average scores, the analysis found. Teaching hospitals comprised one-third of the facilities receiving one star. A number were in high-poverty areas, including two in Newark, N.J., and three in Detroit.

Dr. Kate Goodrich, who oversees Medicare's quality ratings, said in a statement that it has been using the same type of rating system for other medical facilities, such as nursing homes and dialysis centers, and found them useful to consumers and patients. Those ratings have shown, she said, "that publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries."

Dr. Bruce Flareau, chief medical officer for the BayCare Health System in the Tampa Bay region, said he believes patients and their families should use information about hospital quality to make informed decisions about providers. But their research shouldn't end with the ratings, he said.

"It should start there," he said.

Times staff writer Kathleen McGrory contributed to this report.

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