Monday, September 24, 2007

Two ideas, one theirs, one mine

Here's theirs. Sir Brian Jarmin and Dr. Don Berwick today suggested that they would open a new page on the IHI website allowing hospitals that so desired to publicly report their hospital standardized mortality ratio, or HSMR. I have previously posted ours. I think this is a great idea. It would be voluntary, but I think it would also grow in popularity as hospitals get comfortable with more transparency.

Here's my idea. Why don't the insurers in Massachusetts require the hospitals here to report their HSMRs -- in private, with no publicity -- to them, the insurers, as a condition of being in the payers' networks? Why don't they also require the hospitals to submit their most recent Joint Commission survey? In both cases, if the results are out of whack with industry norms, or otherwise indicate quality or safety problems, the insurers could then require remediation plans to remain in good standing.

5 comments:

Anonymous said...

Why the middlemen? Employers and purchasers are the ones that truly influence what the health insurers do; employer contracts are the health insurers lifeblood. What about the big purchasers? The Commonwealth of Massachusetts? Yourself? What if you agreed, on behalf of your employees, to purchase from the first health plan to care about death ratios for hospitals? Employers and purchasers of health insurance have to hear your story, locally and nationally. Your willingness to make this information public is astonishing in the face of an industry that refuses time and again to assess itself honestly and commit to improvement. But the health insurers won't start caring until the purchasers do.

Onehealthpro said...

That's a wonderful idea. Thank you for leading the way.
Onehealthpro

Anonymous said...

As we've just seen with not paying for never events, the health plans in Massachusetts rarely show leadership on any controversial or tough issue. In this case I suspect they'll probably just wait for Medicare to take on the issue...Unless Partners says it's OK first...

Zagreus Ammon said...

Hi Steve,

I just posted some thoughts on http://executivephysician.blogspot.com/2007/09/public-reporting-of-hospital-mortality.html
Let me know what you think, given the competitive environment you're in is also fairly unique.

Anonymous said...

Each payer is also accredited by the National Committee on Quality Assurance (NCQA) and gets surveyed just like hospitals. The payers should be sharing their accreditation results with us in the hospitals.