Helping Consumers Access Information on Providers
Providing consumers with better access to healthcare information continues to be a high priority for federal policymakers. It’s a worthy goal, considering the difficulties facing patients and families when trying to find pricing information for surgical procedures or identify providers with above-average clinical outcomes.
Among the many challenges are the confidentiality of patient-related data under HIPAA regulations, the varying contracts signed between providers and payors, and the lack of standardization in measuring patient outcomes. With those kinds of daunting issues, it’s not surprising that the movement toward greater transparency is occurring at a slow pace.
In February, the Centers for Medicare & Medicaid Services (CMS) took one of those steps by strengthening its Five Star Quality Rating System for nursing homes on its Nursing Home Compare website to give families more precise and meaningful information on quality when they consider facilities for themselves or a loved one.
CMS rates nursing homes on three categories: Results from onsite inspections by trained surveyors, performance on certain quality measures, and levels of staffing. CMS uses these three categories to offer an overall star rating, but consumers can see any of the three individual categories.
If you work in a nursing home setting, it’s important to look at your facility’s most recent rating and be prepared to address any concerns expressed by patients or family members. That’s because CMS’ standards for performance on quality measures are increasing. As a result, CMS said about two thirds of nursing homes will see a decline in their quality measures rating and about one third of nursing homes will experience a decline in their Overall Five Star Rating.
In healthcare, as in other industries, no rating system is perfect. However, consumers increasing rely on rating sites, including Nursing Home Compare, in order to evaluate prospective physicians, hospitals, nursing homes and other facilities.
Therefore, it makes sense for providers to track their ratings and reviews from online sources and social media sites and gauge their reputation in the local market. Having positive ratings and reviews can be a competitive advantage for a provider, while negative ratings and reviews point to issues of perception or reality that need to be addressed.
In any case, healthcare providers can stay in front of this trend toward transparency by gathering their internal data on volume of patients/procedures, pricing, and quality benchmarks, determining what to make public, and then providing that information in a clear and easily understood manner to patients and families.