A hospital system fails to uphold its agreement

There is no single metric for concepts that are as complex and nuanced as quality of care. Nevertheless, people frequently do not want to wade through reams of data in order to assess whether a hospital or clinic provides quality care. As a result, some organizations like to provide a "grade" -- a quick indicator that considers a variety of factors and is supposed to be a reasonable proxy for the general level of care. However, KFF Health News published an article showing why that practices does not always work out.

Six years ago, two health systems wanted to merge, raising anti-trust concerns. Organizations who want to merge frequently argue that the merger will allow them to provide better service at a more affordable cost, while critics of such mergers frequently argue the opposite. To assuage concerns, the merged entity agreed to a variety of quality metrics, to be monitored and graded by government agencies. The article points out, however, that the merged entity "has failed to meet the baseline values on 75% or more of all quality measures in recent years — and some are not even close — according to reports the company has submitted to the health department." Perhaps even more concerning is that the one of the government agencies responsible for overseeing the merged entity has always given it an "A" grade whenever it has issued such grades ("the scoring system was suspended due to the covid-19 pandemic and no grade issued"). Apparently, the issue is that the government agency gives the entity 15 points (out of a possible 100) for merely reporting the measures, contradicting the scoring rubric described in the agency's own documents.

Busy patients could easily be mistakenly reassured by the "A" grade from the government agency. At the very least, it is helpful for the underlying data and the scoring rubric (when available) to be released, even when a general "grade" is released.