Measure Type: Process, Utilization, Cost
The New York State Health Accountability Foundation (HAF) has created report cards available to the public displaying the quality care on nursing homes, hospitals, health plans, and physicians. It carries data on New York and New Jersey’s health plans (HMOs), along with the cost and quality of hospitals. The data is derived from several sources. For the HMO data, the medical reports come from HMO data reports and consumer opinion surveys. For HMO pricing, New Jersey collects data from the State of New Jersey Department of Banking and Insurance, and the New York State Insurance Department provides New York HMO pricing data. Administrative hospital data is derived from New Jersey’s uniform billing data files (UB-92, inpatient), and New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS). The patient safety data is maintained from the ‘Leapfrog Group’.
These report cards display several measures looking at medical insurance, customer satisfaction, and care that patients receive. This is useful tool for patients. They may wish to see the ratings on how good a particular insurance works in a hospital. If the quality of care is poor for a particular hospital, a patient may not be comfortable receiving care and switch to a higher rated hospital. For example, you can compare the overall heart attack rate for all the hospitals of a county to depict which has the best reviews. This data is also useful to hospitals, since it enhances competition among one another. Learning that a rival hospital is exceeding in quality care can nudge other hospitals to aim for the same ratings- if not better.
The report cards offer several keys to interpret how the data is scored. If a provider network has a green circle then it would mean it is significantly higher than a state as opposed to a red circle where it is significantly lower. There is also another type of key (an arrow), which illustrates the changes (whether an increase/decrease/no change) from a year ago. When clicking onto a hospital you are given specific information such as: the average cost for an operation; number of night’s a patient stays over, and the amount of reimbursement from Medicaid.