Four (More!) Reasons To Trust Surgeon-Level Quality Data

We’ve already written about why it’s important to track individual surgeon performance.

But here’s what Ashish Jha, MD, Professor of Medicine at Harvard, said about the critical importance of surgeon-level quality data in the medical journal, JAMA last year.

Dr. Jha’s editorial is aimed squarely at the skeptics. With careful attention to research, he dismantles common objections to reporting surgeon outcomes — most of which come from the surgeons themselves. These skeptical surgeons favor facility-level quality data. However, the evidence suggests that this broader measure doesn’t give patients the information they need. As Dr. Jha put it: “picking the right surgeon is at least as important as picking the right hospital.”

Here are four reasons why. Read more »

How Employers Can Stop Unnecessary Surgery [Whitepaper]

Self-insured employers: how many of your employees get surgeries they don’t need? Evidence suggests the number might be higher than you think.

Physicians say that as much as 11.1% of all surgical procedures are given inappropriately.

Each year, 500,000 patients get heart stents, and 700,000 patients get meniscus knee surgeries that show next to no clinical benefits.

Aside from the risks these unneeded procedures pose to patients, they also come at outrageous prices. The annual cost of unnecessary surgery for every 1,000 employees in your company — about $250,000.

Clearly, inappropriate surgeries are a problem you can’t afford to ignore. But what can your company do about them?

Download the White Paper
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6 Reasons Why Patient Survey Data Doesn’t Tell the True Story

Perceptions of patients have changed. They’re not just “patients” anymore — they’re also “customers.”

And that small semantic difference has big implications for the healthcare industry. One of them is the abundant use of customer-satisfaction surveys.

Enshrined into official healthcare policy in 2010, patient satisfaction now carries serious implications for providers. Hospitals that fail to sufficiently satisfy their patients see significant cuts in their reimbursement for Medicare and Medicaid services. Read more »

The Next Big Innovation in Health Benefits Design: “Surgeons of Excellence”

On its surface, ‘Centers of Excellence’ looks like an intelligent strategy.

Self-insured employers, pursuing cost-efficiencies and streamlined care for employees, select certain hospitals to become provider-partners. They label these partners ‘Centers of Excellence’, and design their benefits packages around them.

But this model only works if employers rigorously scrutinize the provider’s quality of care. Unfortunately, their due diligence sometimes falls short. MPIRICA’s analysis has found that employers frequently select hospitals that may not have the strongest track record for surgical success.

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How Much Can Selecting The Wrong ‘Center of Excellence’ Cost You?

The term “Center of Excellence” (CoE)  is a powerful distinction. Self-insured employers have begun to apply this label to hospitals they partner with to deliver high-ticket, high-volume surgeries — like total knee replacements — to their employees.

For employers, the bundled pricing that CoEs offer (in exchange for a volume of patients) is an attractive prospect. But for the employees, the label means much more.

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Employees Wary of Narrow Networks? Here’s How to Win Them Over

Note: This post, from MPIRICA CEO Shakil Haroon, originally appeared at BenefitsPRO.

Narrow networks might have been born in the 90s, but they came of age in the last five years.

Recent surges in care costs, plus the effects of the Affordable Care Act, have made these plans more attractive to payers. By funneling patients toward a relatively small range of providers, narrow networks help insurers contain costs and improve outcomes. Read more »

An Open Letter to Andy Slavitt, CMS Acting Administrator

Dear Acting Administrator Slavitt:

At MPIRICA, our goal is to promote the ability for patients to make informed decisions based on doctor and hospital quality, and we have been pushing the industry as a whole to empower consumers with unambiguous quality measures based on clinical outcomes.

We saw the Centers for Medicare & Medicaid Services’ (CMS) plan to consolidate 60+ disparate quality metrics, into a single 5 star ratings system on the Hospital Compare website as a generally positive step for patients and the industry as a whole. So when CMS announced in late April that they will delay the release of the updated star ratings, in response to letters from 60 senators (April 11) and 225 congressional leaders (April 18th), we were disappointed. The lawmakers offered no recommendations for CMS to achieve its laudable goal of a greatly simplified medical quality measure. Read more »

What is an acceptable number of deaths from medical errors… for your family?

accept ZERO medical errorsIn healthcare, death goes by another name – mortality.  It’s as if our industry believes using another term lessens the permanent and devastating loss people feel over the death of a loved one. For these people, questions of “how” and “why” will linger for years, and for some, not a day will pass without thoughts of “what might have been” or “if only…”

As to the “how,” for over a quarter of a million families each year, the answer is excruciating: medical error. That’s the heartbreaking finding by Johns Hopkins researchers, published last week in the British Medical Journal, and covered by nearly every major news outlet, including US News and World Report, Washington Post, and NPR. Read more »

Into the New Frontier of Outpatient Surgery Quality

The new frontier of outpatient surgery quality

I’m pleased to bring you news about an exciting development for our company and the MPIRICA Quality Score: we are expanding to include outpatient surgeries!

According to the National Center for Health Statistics, 35 million procedures are performed in outpatient settings annually. When most people think of “outpatient,” the procedures that typically come to mind are sports related injuries like knee meniscus or shoulder rotator-cuff repair. However, the reality is that even advanced surgeries have moved out of inpatient settings. In fact, Blue Cross Blue Shield recently reported that 82% of spine surgeries are now performed in an outpatient setting. Unfortunately for patients wondering about the quality of outcomes from outpatient surgeons or facilities, there is nowhere to turn because the data simply does not exist. Read more »

A Top Scoring QB Deserves a Top Scoring MD

Peyton Manning by Jeffrey Beall (Flickr) [CC BY-SA 2.0], via Wikimedia Commons / captioned and attributed

Peyton Manning is THE man at the center of whirlwind attention as the Denver Broncos battle for the title of World Champion in Sunday’s historic Super Bowl 50. This week, ESPN (and dozens of news outlets) ran stories and video clips detailing how the multi-MVP quarterback was told that he would “eventually” need hip replacement. USA Today even suggested that the news “may be surprising,” but with over 300 sacks and countless other tackles taking Manning down during his 17 year career in the NFL, it should surprise no one that his hip has taken a beating along with the rest of his body.

Nevermind Manning’s conversation with his doctor occurred over two years ago, or the fact that a hip replacement likely won’t happen for at least a decade or two, the “news” does beg a more serious question: how should Manning pick his next doctor? Especially given that he hasn’t had the best of luck with surgeries?
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