Hospital Quality Methodology

The Find a Doctor & Estimate Costs tool presents two types of hospital quality scores:

  1. Patient Experience: Hospital scores come from the Hospital Consumer Assessment of Health Plans Survey (HCAHPS). These scores are displayed within the Ratings & Reviews module on a hospital's profile page.

  2. Safety and Effectiveness: Hospital scores are based on data submitted by hospitals to the Centers for Medicare and Medicaid Services (CMS). These scores are displayed as one to three ribbons within the Quality module on a hospital's profile page.
     
    • One ribbon means the hospital's performance on this measure was below expectations
    • Two ribbons means the hospital's performance meets expectations
    • Three ribbons means the hospital's performance exceeds expectations
    Lower scores may mean that a hospital doesn't perform as well in specific procedures, but it doesn't necessarily mean that the hospital doesn't provide acceptable overall care. Additionally, a hospital may have scores for some measures and not have scores for other measures. Scores may be missing because a valid, reliable measure for a medical procedure isn't available, or because there isn't enough data to objectively calculate performance scores.

Results for hospital quality scores are updated quarterly and reflect the most recent data.

What patient experience measures are used?

Patients provide feedback on topics such as communication, pain management, and the cleanliness and quietness of the hospital environment. Find a Doctor displays hospitals' scores on ten patient experience measures from HCAHPS: 

  • Overall rating of hospital
  • Willingness to recommend hospital to family and friends
  • How often nurses communicated well with patients
  • How often doctors communicated well with patients
  • How often staff explained medicines before giving them to patients
  • Whether patients were given information about what to do during their recovery at home
  • How often patients' rooms and bathrooms were kept clean
  • How often the area around patients’ rooms was kept quiet at night
  • How often patients received help quickly from hospital staff
  • How often patients' pain was well controlled

Where does the patient experience data come from?

HCAHPS is a national, standardized survey administered to a random sample of hospital patients, 18 years of age and older, within 48 hours to 6 weeks after discharge from the hospital. The survey aims to gather the patient's thoughts on care, and how they feel about the care they received. The survey's results can help you compare patients' experiences among various hospitals and against state and national benchmarks.

CMS is responsible for overseeing the survey and makes the results available to the public. The data displayed on the Find a Doctor & Estimate Costs tool represents patient feedback captured by these surveys. The results are updated quarterly and reflect the most recent four quarters of data. More information is available at hcahpsonline.org.

What measures of safety and effectiveness are used?

CMS adopted a standard set of performance measures for recommended hospital care for certain conditions such as heart attacks, heart failure, and pneumonia. Hospitals are evaluated on how well they follow the recommended processes of care for each condition. Hospitals are also evaluated on how well they are able to avoid medical and surgical complications for their patients.

The Find a Doctor & Estimate Costs tool displays scores for up to eight quality measures:

Four process measures:

  • Acute myocardial infarction (heart attack)
  • Heart failure
  • Pneumonia
  • Overall surgical care infection

Four outcomes measures:

  • Medical complications
  • Surgical complications
  • All patient mortality
  • Length of stay