How to Use New Medicare Hospital Tools

Knowing hospital costs and treatment results can influence patient-doctor choices.

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There are about 5,500 hospitals in the U.S. I can name perhaps 20 to 30 of them, maybe a few more if you gave me a lot of time and even more hints. Which Minnesota hospital has the same name as the shortened name of a popular sandwich condiment and potato salad ingredient? Even in my own back yard, my hospital name recognition prowess is putrid. In part, that's because I have a pitiful memory but it's also because I've been lucky enough over the years to largely avoid hospital visits. However, as I get older, I spend increasing amounts of time at various hospital offices either getting tested, having appointments with medical practices located in hospital complexes or having outpatient procedures to attend to the aches and pains I've come to associate with my very own special aging process.

[ See Low CPI Creates Medicare Winners and Losers.] I've also been generally clueless about the hospital affiliations of the doctors who tend to me. But as my date with Medicare destiny gets closer, the importance of making the right decisions about which hospitals I should patronize is becoming increasingly clear. Fortunately, so is the information about hospital costs and performance. The federal Centers for Medicare & Medicaid Services (CMS) just finished an upgrade to the hospital information available to consumers.

The new information measures death rates at hospitals from heart attacks, heart failure and pneumonia. It also tracks the rate at which patients wound up being readmitted for these problems because, in many cases, they weren't properly taken care of during their initial hospital stay. High rates of readmission are a black mark for the level of hospital care, and an expensive one at that. Studies show that time spent in a hospital can make patients worse, not better, due to hospital-borne infections and errors in prescribing drugs and treatments.

To use the new information, go to Medicare's Hospital Compare tool. Click on "Find and Compare Hospitals" and then pick hospitals near you, either by naming a city, a state, or entering your ZIP code and choosing hospitals within certain distances of your ZIP. Next, you will be asked to make a general search of hospitals in your chosen geographic area or to search on a specific medical condition or surgical procedure. I'd suggest you begin with the general search and then do a more specialized search later as needed.

(The medical conditions included in Hospital Compare are heart attack, heart failure, chronic lung disease, pneumonia, diabetes in adults, and chest pain. The surgical procedures are angioplasty procedures, heart bypass surgery, heart valve operations, insertion of heart defibrillator, pacemaker implant, major heart and blood vessel procedures, head and neck blood vessel operations, gallbladder removal, hernia operations, intestine operations, stomach and esophagus operations, back fusion, neck fusion, back and neck operations, operations on upper extremities (arm and shoulder), operations on lower extremities (such as hip, knee, ankle), other bone procedures, bone removal, kidney and bladder operations, other kidney and bladder operations, prostate removal, and female reproductive operations.)

When you choose the general search option you'll get a list of all hospitals in your area. You can check off up to three at a time for side-by-side comparisons. What you'll see is a long list of quality measures that are based on tests and other procedures that should be provided to patients. Near the bottom of the list, you'll also see the new information on death and readmission rates. Here, hospitals are rated as worse than, equal to or better than the U.S. average. That's better than nothing but you should be aware that nearly all hospitals are graded as average, with a small percentage in the "above average" group and an even smaller number in the "worse than" average group. In the case of mortality rates for heart attacks, for example, Medicare looked at data from 4,609 hospitals. It dropped 1,610 from consideration because they didn't have enough cases. That left 2,999, and among these, it listed 2,814 -- nearly 94 percent -- as average, 131 (4.4 percent) as better than average and only 54 (1.8 percent) as worse than average. A CMS spokesperson declined to explain its reasoning for the small numbers of non-average hospital performance designations. It is possible to get precise numerical results for each hospital and make your own comparisons but you will need to download the government's database yourself and review some massive spreadsheets to find the haystack needles you seek.

[See also The Nation's 10 Costliest Medicare Markets.]