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Bringing Transparency Back? CMS will Resume Reporting on Dropped HACs but not for Hospital Compare

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surgical sponge surgeonsThe Centers for Medicare & Medicaid Services (CMS) provides insurance coverage to 100 million people and has been a vital source for information about hospital-acquired conditions (HACs) for years. HACs include a variety of hospital mistakes from preventable infections to medical instruments left in body cavities. Healthcare consumers and researchers rely on that data to compare quality of hospitals and determine which hospital mistakes are most prevalent.

Or at least they did, until CMS pulled data about eight HACs from its consumer-friendly Hospital Compare website last summer, effectively cutting off the average consumer’s capability to pick a hospital based on, for example, how many people were given the wrong blood type. While CMS maintained a public spreadsheet with a less-comprehensive table of 13 preventable HACs, it was only available to those who knew how to find it and read it.

Then last month, USA TODAY reported that the eight HACs that were pulled from Hospital Compare were missing from the less-accessible spreadsheet, too. Suddenly, hospital safety-ratings websites like non-profit Leapfrog Group that had been translating the agency’s tables and figures about the rate of life-threatening mistakes like air embolisms and surgical sponges left in body cavities into useful information for healthcare consumers couldn’t even do that.

Now, CMS is reversing course, promising to resume reporting on the eight conditions and release it in a publicly available spreadsheet. The information will not return to the Hospital Compare site, however. CMS spokesman Aaron Albright said the reason the agency stopped reporting on certain conditions is to focus on what is “most relevant to consumers”. Some new data also adopts more reliable measurements, such as those used by the Centers for Disease Control and Prevention on bloodstream infections.

In essence, the agency wants to report on the most common medical mistakes because it has determined that is what’s most important to people when choosing a hospital. The HACs that were dropped from the list are the “never events” our firm has written about: mistakes that should never ever happen in hospitals. According to CMS, never events are rare and should thus be a negligible consideration in a consumer’s decision.

Some patient-safety advocates disagree that information about the rate of never events like surgical instruments left in body cavities isn’t relevant to consumers. Taking that information out of their hands makes it even more important for them. Under The Affordable Care Act, the 25% of hospitals with the highest rates of some HACs lose 1% in Medicare reimbursement. If it’s important enough information to lose funding over, it’s important enough information to share with consumers.

As a healthcare consumer, I can say that I want to know what kinds of mistakes the hospitals in my area have made, and how often. A “rare” mistake, if egregious enough, may change my decision about whether to visit a certain hospital. It is the consumer’s prerogative to determine what hospital information is pertinent to make an informed decision about his or her care. It is CMS’s responsibility to provide consumers the best information about the widest variety of factors, in an accessible way.

AM