January 21, 2000
Council inquires about health-care assessment tools state was to develop
The Business Council is asking the state Health Department to investigate why no standards for evaluating hospitals and doctors have been produced since lawmakers allocated money for that purpose in 1996.
With Business Council support, the Health Care Reform Act (HCRA) of 1996 included funding to develop quality-measurement tools to help consumers and employers evaluate hospitals and doctors.
"To date and nearly three years later, not a single measurement has been established," Elliott Shaw, director of government affairs for The Council, noted in a Dec. 17 letter to Antonia Novello, commissioner of the state Health Department.
Shaw noted that employers have supported such assessment tools nationally and statewide.
For example, employer groups helped form the National Committee for Quality Assurance (NCQA), a private not-for-profit entity that gathered much data for this purpose.
Employers often insist that health plans have NCQA accreditation before they even bid to offer health insurance to employers, he said.
And in New York, employers also supported the Health Department's Quality Assurance Reporting Standards (QARR) for health plans.
As a result, there are at least three different web sites with ample information on health plans-but only one that provides comparable detail on hospitals or doctors.
That site, which is available from www.health.state.ny.us, provides information on hospitals' risk-adjusted mortality rates for coronary artery bypass surgery and angioplasty, and information on any disciplinary actions against physicians performing these procedures.
"That's important information to have about providers of health services but it is embarrassingly little if you need hip replacement surgery or use any of the hundreds of other services performed by physicians in their offices or hospitals," Shaw said.
"Lack of progress on this frontier of quality measurement indicates a need to make it a higher priority," he added.
Shaw noted that a recent national ranking of 3,000 acute-care hospitals' mortality rates and average length of stay yielded poor grades for the 187 New York hospitals ranked.
In mortality rankings, four New York hospitals were in the top quartile, seven were in the next, 21 were in the third, and 155 were in the lowest. In length-of-stay rankings, no hospital was ranked in the top quartile, one was in the second, five were in the third, and 180 were in the lowest.
"Expanding the scope of report cards on surgical procedures and provider profiles would create an atmosphere of high-quality expectations that will drive New York providers to even higher-quality performance, Shaw wrote.