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    Officials Want Patients to 'Shop,' Hospitals to 'Compete'

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    Gov't Launches Hospital Comparisons Site

    March 28, 2008 -- Federal health officials released the latest version of a web site Friday that lets the public compare about 2,500 hospitals on some measures of quality.

    The site pulls together some information that Medicare has made available to the public since 2005. Officials say the effort would force hospitals to compete more on quality and customer services while allowing patients to shop.

    "I think by this afternoon there will be hospitals looking at this site and identifying the places they need to improve," says Health and Human Services Secretary Michael O. Leavitt.

    Administration officials have sought to bring more transparency to the health caremarketplace. Similar Medicare sites compare nursing homes in all 50 states as well as customer satisfaction with government-sponsored private managed care plans.

    The site, at, compares hospitals according to how often they meet 26 performance measures, based on Medicare data. Most are process oriented, such as how often hospital personnel give aspirin to heart attack patients, a treatment shown to cut the risk of another attack.

    There's also patient satisfaction measures gleaned from surveys filled out by adults, including those with Medicare.

    Two measures -- admission for heart attack or for heart failure -- give a sense of death rates for patients within 30 days of hospital admission. The site doesn't give each mortality rate. Instead it displays whether death rates at the hospital are at or below the national average.

    Many hospitals and other health care providers have resisted publishing detailed outcomes data. One concern is that hospitals that routinely treat sicker patients could be penalized for poorer outcomes.

    "It's still in the beginning stages, we realize that," says Elizabeth Leitz, a spokeswoman for the American Hospital Association, which leads the group that chose the site's comparison measures. "It's what we have consensus built around," Leitz says of the two health outcomes metrics on the site.

    The group plans in July to introduce comparisons of average pneumonia death rates for hospitals, she says.

    Leavitt acknowledges that the site does compare hospitals on many measurable health outcomes, like the success of surgery or infection rates. He likened consumer health information to the development of video games over the last 40 or so years.

    "We're looking at ‘Pong'," he said, referring to the rudimentary 1970s video game. "We're still learning."

    But he said the effort -- while supported by hospitals and other health providers -- also contends with resistance. Leavitt says there was a "tension" between health providers who want independence and employers who need to cut rising health costs.

    "There's an understandable caution, but we have an imperative we have to accomplish here," Leavitt says.

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