Why don't the insurers in Massachusetts require the hospitals here to report their HSMRs (hospital standardized mortality rates) -- in private, with no publicity -- to them, the insurers, as a condition of being in the payers' networks?... [I]f 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.
Dumb idea, it turns out. As Liz Kowalczyk reports in the Boston Globe, an expert panel that has been studying the measurement of hospital mortality rates has found that the "current methodology for calculating hospital-wide mortality rates is so flawed that officials do not believe it would be useful to hospitals and patients."
Researchers evaluated software of four companies for measuring hospital mortality. "The problem was that researchers came out with vastly different results when they used the various methodologies to calculate hospital mortality between 2004 and 2007 in Massachusetts, and they could not tell which company's results -- or if any -- were accurate."
Our hospital's head of health care quality, Dr. Ken Sands, was on the panel. He is quoted in the story as saying:
"In every year there were at least a couple of hospitals ranked as having low mortality with one vendor, and high mortality with another. That hospital could either be eviscerated or rewarded depending on which vendor you choose."Fortunately, there are other metrics that can reliably measure aspects of the quality and safety of hospitals. Death will just have to wait.