Hospital rankings, popularized by agencies such as Healthgrades, Leapfrog and the Centers for Medicare and Medicaid Services, can provide a general snapshot of a hospital's overall quality. But even hospitals that rank highly on general scores may fall short when it comes to individual procedures, according to a FairChex study.
Take the Mayo Clinic and Johns Hopkins, for instance. Both are world-renowned hospitals, and both were placed highly on U.S. News and World Report's list of best hospitals at first and fourth, respectively; Johns Hopkins didn't have enough information to earn a score from CMS, but the federal agency gave the Mayo Clinic five stars, its highest honor.
[Also: Full list: These 20 hospitals earned 'F' grades in the Fall 2016 Leapfrog patient safety ratings]
Yet neither is a particular good place in which to get a spinal fusion procedure. They both rank in the bottom quartile in the country when it comes to that service.
FairChex found that, depending on the procedure, consumers looking at hospital ratings may choose a hospital for care not knowing they perform poorly in a certain procedure, effectively resulting in poor quality delivered at the highest cost. That has implications beyond just a procedure's efficacy. In the United States, medical error is the third leading cause of death, behind only heart disease and cancer. Estimates range from 250,000 to 400,000 annual deaths as a result of preventable medical error, with another 4 to 8 million seriously injured, according to the Journal of Patient Safety.
[Also: Full list: These 844 hospitals earned an 'A' in the Fall 2016 Leapfrog ratings]
On top of that, the U.S. Department of Health and Human Services estimates that hospital readmissions -- which indicate a patient didn't get the best care possible -- account for roughly $17 billion in Medicare expenditures annually. That's about 2.8 percent of all Medicare spending.
Examining individual procedures among the country's top 20 hospitals, as ranked by U.S. News and World Report, is revealing. The Cleveland Clinic, for example, places second on the list, and yet it's in the lowest 1 percent in national quality when it comes to heart failure treatment. New York Presbyterian Hospital is sixth on the list and falls in the bottom 1 percent in orthopedic care, and UC San Francisco Medical Center at Parnassus, ranked seventh, is in the bottom one percent for hip fracture repairs.
[Also: Full list: See how hospitals scored in the new Overall Star Ratings from CMS]
The recommendation from FairChex is to redirect patients from low quality/high cost facilities to high quality/low cost alternatives, which in the short term could save an estimated $100 per year per person, or $25 billion annually. In the long term, the group contends, the dynamic effects of competition on hospital leadership would lead to better quality and lower cost of care.
Twitter: @JELagasse