U.S. Hospital Quality on the Rise, but Quality Varies
ST. LOUIS, (BUSINESS WIRE) October 17, 2004 - Of the nation's top 25 metropolitan areas, hospitals in Cleveland have the best overall quality performance in 2003, followed by Detroit, Minneapolis-St. Paul, Phoenix and Tampa. Phoenix shows the best quality improvement for the four-year period (2000-2003), followed by Detroit, Cleveland, Houston and St. Louis.
The HealthGrades study annually rates the quality of each of the nation's nearly 5,000 hospitals in 28 separate procedures and diagnoses, from treating a life-threatening heart attack to life-altering knee replacement surgery, with each hospital given a one-, three- or five-star rating.
This year, the study found that:
- Overall mortality rates associated with cardiac disease-related hospitalizations and community-acquired pneumonia hospitalizations decreased significantly from 2000 to 2003.
- All 25 MSAs reduced in-hospital mortality rates in heart attacks, congestive heart failure and community-acquired pneumonia.
- The greatest performance improvement was associated with coronary artery bypass graft surgery. Americans in 2003 had a 21 percent better chance of surviving this procedure compared to 2000. However, this improvement in survival rates varied widely depending on the city where the procedure is performed.
- The top five MSAs for overall quality performance - Cleveland, Detroit, Minneapolis, Phoenix and Tampa - consistently performed in the top half on all of the procedures and diagnoses studied in 2003.
- Heart attack hospitalizations had the least variation in outcomes across the 25 MSAs studied in 2003.
But the study also found a wide disparity in care quality from city to city. For example, in 2003, a patient had more than twice the chance of dying from bypass surgery in Cincinnati compared with San Diego.
"When we looked at the data, we were very pleased to learn that overall hospital quality is improving," said Samantha Collier, MD, HealthGrades' vice president of medical affairs. "But it's important to note that quality varies widely from hospital to hospital and from procedure to procedure. We encourage everyone to do their homework and research hospitals before they check in."
"HealthGrades didn't study the reasons why overall quality for these five procedures and diagnoses has improved, but some of the likely reasons are enhanced technology, pharmaceuticals, and training, and the movement toward the evidence-based practice of medicine," noted Dr. Collier.
"For example, mortality rates decreased in several key areas of heart care, which is likely due to a national focus on holding hospitals accountable for implementing and adhering to best-practice clinical processes such as timely intervention and administration of aspirin and beta-blockers to heart attack patients on arrival to the emergency room," said Dr. Collier.
Companies and Employees Continue to Struggle With Double-Digit Health Care Rate Increases
ST. LOUIS, (BUSINESS WIRE) October 17, 2004 - U.S. health care cost increases escalated sharply again this year, but may begin moderating next year, according to global human resources services firm Hewitt Associates (NYSE:HEW). For 2005, Hewitt is projecting an 11.3 percent average increase for employers, which is lower than 2004's 12.3 percent increase.
While most large companies will continue to absorb the majority of next year's cost rate hikes, many are struggling under the continued double-digit increases, and are making plan design changes, such as raising copayments, deductibles and out-of-pocket limits, and increasing employees' share of health care premiums. Hewitt projects that the average employee contribution for 2005 will be $1,481, representing 19 percent of the overall health care premium, and up from $1,288 in 2004.
Double-digit rate hikes will continue to affect nearly every major U.S. city next year, after most already experienced significant increases in 2004.
Hewitt data reveals that the following cities recorded the highest rate increases in 2004: Memphis (22.6%), Pittsburgh (19.1%), Cincinnati (18.5%), Charlotte and Raleigh (17.3%), Hartford (16.9%), San Francisco (15.9%), Milwaukee (15.7%), Dallas/Fort Worth (15.5%), and Phoenix and St. Louis (both 14.9%).
"While there are many different variables that factor into regional health care cost increases, one of the most powerful drivers is the level of consolidation in the market," added Bruner. "Plans and providers continue to merge in many cities, reducing the purchasing power and number of options available to employers."
"Rapidly increasing health care costs continue to be a major burden for employers and employees," said Jack Bruner, national health care practice leader, Hewitt Associates.
"While this problem is clearly not going away, there are some signs of moderation indicating that the cost savings initiatives employers began implementing several years ago--such as disease management and wellness programs and a focus on greater consumerism--are beginning to bear fruit in terms of reducing hospitalization costs, helping to stabilize prescription drug costs and driving more effective utilization," stated Bruner.
In addition to consolidation, other primary drivers for health care cost rate increases include prescription drug increases, cost for new medical treatments and technology, liability concerns (which could heat up if the Patient Bill of Rights is resurrected), an increasing cost shift from a growing uninsured population and the fact that a large percentage of Americans are either at or approaching an age when they will require more health care.
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