What If . . . There was a Hospital Quality Score

In 2001 the Institute of Medicine published their second great work entitled, Crossing the Quality Chasm. In that work, the IOM defined six (6) dimensions of healthcare; the essentials in yielding a "quality" healthcare product. These dimensions can be easily remembered via the acronym STEEPE:

• Safety
• Timeliness
• Effectiveness
• Efficiency
• Patient Centeredness
• Equity

What if there was a Hospital Quality Score (HQS) that could be applied to all U.S. hospitals?

This score would be comprised of indicators that aligned with each of the six dimensions. The National Quality Forum (NQF), Leapfrog, and The Joint Commission, collaboratively, could develop the hospital-specific indicators and provide the necessary definitions and mathematical algorithm.

The HQS could be used by both CMS and commercial payers to assess provider and organizational quality.

These dimensions are applicable across the board. However, the HQS could be divided into classes (i.e. Large Urban, Large Urban Teaching, 350-450 beds, 349-250 beds, 249-150 beds, Rural, Critical Access) to account for hospital size.

What would be the response from the American Hospital Association (AHA) if a hospital quality score was presented to the market? Clearly, commercial payers would use such a score to negotiate contractual rates. CMS could use the score to leverage reimbursement rates. Furthermore, the HQS could be publicly reported in the same manner in which Core Measures are currently.

Yet, the HQS could not feasibly change month to month. The score would be submitted twice a year and reporting (including benchmarking) would mirror such a process.

What if . . .