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Any hospital interested in figuring out how it’s doing compared to others in its state has a new on-line resource for finding data on length of stay, charges, number of cases, and mortality rates. MetroHealth America, based in Jackson, MS, has revamped its on-line product, Healthmart.net to better allow providers — as well as consumers and payers — to compare their performance to others, says company president Cy Rosenblatt.
One of the newest features is a report card that grades hospitals on a 5-1 scale by (diagnosis related group) DRG, Rosenblatt says. He initially created the feature to assist consumers, but his clients have been telling him it’s a boon to them, too. The grade is based on mortality, length of stay (LOS), and charges, with a 5 being a hospital in the top 5%, and a 1 being a hospital at the bottom of the heap. (For more on the report card feature, see chart below) "The score is predicated on a risk adjustment calculation that a PhD biostatistician developed for us," Rosenblatt explains. "It allows a hospital to quickly look at a particular DRG and determine if they have to focus on that for improvement."
One client last year saw the report card — the first table that pops up on a search — and was so intrigued he stopped Rosenblatt’s presentation from continuing. "He saw that for a given DRG, his hospital was in the top 5% of all hospitals in the country for length of stay," Rosenblatt recalls. "But they had been focusing on that very topic for that DRG. It showed him they were already doing well and should refocus on other areas. We were pleasantly surprised to find out that the report card feature has utility for administrators and those trying to manage DRGs."
The site also now has the ability to group data by disease grouping. "Most sites that put out this data focus on DRGs," he notes. "We looked at the data and grouped the 11 million claims into diseases so that if you are interested in the condition, not the billing information, you can do the same sort of searches." For instance, a user could look up myocardial infarction and see how his or her facility compared to others. "It’s more flexible than DRGs. There are around 500 of them, but one can cover a multiple of conditions. It’s a great way to look at the financial side, but not as direct as looking up a condition."
Procedures can also be tied back to a particular DRG on the site, Rosenblatt says. That new feature comes in particularly handy for life care planners who are trying to estimate the cost of care for particular payers. "It takes you to the most likely DRG a procedure would be billed under."
The other change in the site came because of patient confidentiality concerns. Because some facilities deal with only a few cases of particular conditions, including mortality rates could allow someone to tie a particular death back to a specific individual. The Centers for Medicare and Medicaid Services (CMS) asked MetroHealth America to change its mortality reporting, and Rosenblatt obliged. Currently, only report card mortality ratings are available.
Life care planner Maureen Pavlik, RN, BS, CCM, CLCP, CRRN, of National Healthcare Resources in Pittsburgh says that being able to look at a particular DRG for both specific hospitals and regions is a real boon to her. "Knowing that the costs for procedures and hospitalizations are based on Medicare data, I feel comfortable using the figures as a frequent reference," she says. "I combine the cost figures with statistical frequency of occurrence found in journal articles regarding potential complications in a given disability population, such as spinal cord injury."
And although costs for things to come can never be projected with exact certainty, Pavlik says a general projection is helpful, particularly when combined with data from economists about inflationary calculations.
According to J. Phillip Macon, president of the Jackson, MS-based consultancy J. P. Macon & Company, the program is of particular value to facilities interested in checking out their performance in cardiovascular treatments.
"Hospitals use it to identify those areas of treatment that need gains in efficiencies," explains Macon, who has worked extensively with MetroHealth America and some of its clients. "Improvement in the treatment process is warranted if hospital X’s’ length of stay or its morbidity/mortality is significantly higher treating patients with pneumonia than hospital G.’"
The potential uses extend beyond the obvious, though, he adds. It can include fraud and abuse, with the premise being that a higher than normal cost and/or morbidity and mortality rating might correlate with poor government billing compliance. It could be used for litigation support, strategic market planning, and underwriting risk assessments, too.
Rosenblatt acknowledges that there are plenty of data purveyors out there. What makes his different is that users are given all the data for a particular state when they do a search. (In our sample tables, Healthcare Benchmarks used only Seattle-area hospitals because of space constraints.) But the data aren’t limited: there are regional and national comparisons provided in the same search. Combined with the report card snapshots, Rosenblatt says there are few data vendors that could match his products depth for the money: a yearly subscription for an individual user is just $119. Users who sign up get three free searches initially and can then subscribe if they wish for that fee.
The data are updated yearly, and during the course of the year new features may be added or existing ones tweaked depending on the feedback Rosenblatt gets from customers. In addition, clients have the option of ordering custom data, too.
Not a lot of change is planned for the coming year, Rosenblatt says. "I did a lot of changes in the last couple years. But I’ve tried to make the site user friendly, and I think it’s something that is easy enough to use intuitively."
[For more information, contact:
• Cy Rosenblatt, President, MetroHealth America Inc., 2635 Ridgewood Road, Suite A, Jackson, MS, 39216. Telephone: (601) 362-9900.
• Maureen Pavlik, RN, BS, CCM, CLCP, CRRN, Life Care Planner, National Healthcare, Resources, Riverside Commons, 700 River Avenue, Suite 400, Pittsburgh, PA 15222.
• J. Phillip Macon, President, J. P. Macon & Co., 3759 Crane Blvd., Jackson, MS 39216-3606. Telephone: (601) 362-8282.]