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Hospital Ratings: What Do They Really Mean?


From WHIO, a news talk radio station in Dayton, Ohio, comes word that four area hospitals rank in the 'top five percent nationally for emergency care.  That is impressive, I guess.  If you have an emergency, your chances of having a good outcome in one of them are probably pretty high.  At least that's a reasonable assumption. The story went on to say that HealthGrades, the outfit that gives the awards, evaluates the hospitals based on their mortality rates for 11 of the most common conditions for patients needing emergency treatment.  Furthermore, only 255 of the 4,900 acute care hospitals in the country got the award.  A viewer might be doubly impressed.

But the story gave no information about HealthGrades, its pedigree, expertise in ratings, or most important, what it stands to gain by rating the nation's hospitals.  The four Dayton-area hospitals may be fine places for emergency care and other conditions, but readers should know more about who gives the awards in order to make their own judgments about whether they will be in good hands when the ambulance leaves them at the entrance.

That's the problem with this and other hospital rating schemes with 170 or so to choose from at last count. .When the media toss them into their stories with little explanation as WHIO did, ' it's really hard for the consumer/patient to know which rating schemes are on the up and up. Some are created by the government such as Medicare's Hospital Compare site; some come from non-profit organizations like the California Healthcare Foundation; ' and some, like HealthGrades,'  make a profit by steering consumers to hospitals, doctors, and nursing homes that they say meet their ratings criteria.'  Creators and supporters of these rating programs say that giving consumers information will lead to improved quality of care.

In the last year or so, I interviewed folks from HealthGrades for another project and learned that the relationship between the firm and the hospitals is not exactly arms length. One of the company officials explained that if any hospital or health business rated by HealthGrades wants to use a HealthGrades star rating, it must sign a licensing agreement, and the licensing fee gives the hospitals the right to use the ratings in their advertising and promotional materials.'  Some percentage of hospitals that receive the designation of 'distinguished hospital for clinical excellence' also sign licensing agreements.  The hope is that good ratings translate into more patients, which, of course, is the endgame whether the hospital operates as a for-profit or as a more traditional not-for-profit institution. In other words, the ratings are powerful marketing tools for hospitals in Dayton and everywhere else.

So where does that leave the consumer or patient? Ask lots of questions and investigate different sources of information before plunking down money for some report.  You may be able to get the same or similar information without paying a dime.  A quick Internet search indicates that people who purchased reports from HealthGrades have complained about the company's billing practices. Some complained of recurring credit card charges after ordering a single report and noted the trouble they had getting unauthorized charges removed.'  Health care shoppers hardly need those headaches.

More Blog Posts by Trudy Lieberman

author bio

Trudy Lieberman, a journalist for more than 40 years, is an adjunct associate professor of public health at Hunter College in New York City. She had a long career at Consumer Reports specializing in insurance, health care, health care financing and long-term care. She is a longtime contributor to the Columbia Journalism Review and blogs for its website,, about media coverage of health care, Social Security and retirement. As a William Ziff Fellow at the Center for Advancing Health, she contributes regularly to the Prepared Patient Blog. Follow her on twitter @Trudy_Lieberman.

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