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Patient Choice of Surgeon or Hospital: Does it Really Matter?

Posted By Louise Probst, Thursday, February 16, 2017
The BHC's member meeting conversation last December focused on information from two national organizations that had boldly and publicly reported performance ratings for surgeons: Propublica and Consumers' Checkbook. Their analyses were based on millions of Medicare claims and both showed large differences in patient outcomes across individual surgeons.  
As a reminder, for total hip and knee replacements, where death is a rare occurrence, Consumers' Checkbook reported the best surgeons had overall bad-outcome rates (deaths, complications, and readmissions) of less than 8 percent, while the worst-performing one-tenth had overall bad-outcome rates of more than 21 percent.
Recently, researchers from the Harvard T.H. Chan School of Public Health asked: Do patients who receive care at a high quality hospital spend less? Using Medicare claims data to assess 90-day episode cost for five major surgical procedures, which included hip replacement, their answer was "yes". Superior surgical quality translates into lower mortality, higher patient satisfaction, fewer readmissions, and lower Medicare spending on post-acute care. 
Two common measures of surgical quality were assessed: 30-day surgical mortality rates and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.
Patients who had surgery, which included hip replacement, at high-quality hospitals cost Medicare less than those who had surgery at low-quality hospitals. Adjusted spending differences of nearly $2,700 in the first 30 days of care were found to be largely driven by the cost of care in the weeks following surgery. 
Interested in helping your employees use information to find better value care? The BHC can help - just give Patti or Louise a call at 314-721-7800.  
Warm regards,
Louise Probst
BHC Executive Director


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