HealthGrades
Encyclopedia
HealthGrades Inc. is a U.S. company that develops and markets quality and safety ratings of health care providers, including hospital
s, nursing home
s, physician
s and dentist
s. Quality ratings are devised from publicly available patient safety data and analyzed with proprietary technology developed by HealthGrades. In addition to these ratings, HealthGrades offers consulting services to health care providers to improve safety and enhance marketing and public relations.
, was founded in 1999 by Kerry Hicks, who served as president and CEO of the predecessor Specialty Care Network from 1995 to 1999. HealthGrades grew steadily and in 2008, the company purchased Alijor, an internet company that gave health care providers the ability to display information about their business, including location(s), hours, insurance acceptance and credentials. Consumers could search the Ailjor site to find a health care provider that met their needs. Hicks grew HealthGrades into one of Colorado's largest public companies (formerly ) until Vestar Capital Partners
acquired the company in 2010 and took the company private.
claim data, and include all hospitals that are Medicare participants. Some critics insist that medical records should be used instead of claim records which do not include factors that affect patient outcomes. Ratings are updated yearly, but data is two years old before Medicare releases it. Therefore, the 2011 ratings are derived using data from 2007-2009.
HealthGrades develops objective ratings based on data and information obtained from several sources, mostly available to the public. The data is analyzed using a proprietary methodology that identifies the recipients of the various awards and the "1-3-5 Star" designation. Specifically, most ratings are determined from multivariate
logistic regression
s of medical outcomes at a given healthcare provider and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively. The ratings have been criticized for oversights in the methodology that may actually penalize some institutions with ideal medical outcomes. Because HealthGrades' algorithms are proprietary, outside experts have "expressed concern about the reliability and validity of such 'black box' rating scales."
In addition to "Star" ratings, HealthGrades identifies facilities for their Top 10% in the Nation, Top 5% in the Nation, America's 50 Best Hospitals, Distinguished hospital award for Clinical Excellence, and Excellence Awards in 26 areas:
Outstanding patient experience, Patient safety, Pediatric patient safety, Women's health, Bariatric surgery, Cardiac care, Cardiac surgery, Critical care, Coronary intervention, Gastrointestinal care, Gastrointestinal surgery, General surgery, Gynecologic surgery, Heart transplant, Joint replacement, Kidney transplant, Liver transplant, Lung transplant, Maternity services, Orthopedic services, Prostatectomy, Pulmonary care, Spine surgery, Stroke care and Vascular surgery. Emergency medicine, HealthGrades newest rating area, was added in 2010.
listed the HealthGrades website as one of the 50 best on the internet for 2011. The site has 11 million unique visitors each month across all web properties. Many prominent companies and health plans make HealthGrades information available to their participants.
BetterMedicine.com is also a member of the HealthGrades company.
in 2006 for copyright and trademark infringement after the hospital used HealthGrade's ratings and logo in promotional publications without paying licensing fees.
A 2004 report in the Rocky Mountain News
concluded that HealthGrades had inaccurate physician disciplinary records (while competitor ChoicePoint
had much greater accuracy). The report also detailed the complaints of former HealthGrades employees and physicians that pursued legal actions after inaccurate reports.
A 2002 study published in JAMA
reported that HealthGrades ratings for mortality
associated with acute myocardial infarction identified "groups of hospitals differing in the aggregate in quality of care and outcomes" but heterogeneity within the ratings for individual hospitals could not reliably discriminate between individual hospitals in quality of care or mortality. To illustrate: for any pair of hospitals rated to two different rating groups (1-, 3- or 5-star) by HealthGrades, the researchers determined that standardized mortality rate
s were "comparable or even better in the lower-rated hospital in more than 90% of the comparisons".
A 2011 study published in Archives of Surgery
evaluated HealthGrades and US News & World Report ratings in oncologic surgeries
, comparing top-rated hospitals in the two reports to all other U.S. hospitals. The authors determined that both ratings systems had substantive flaws in the evaluation of mortality following pancreatectomy
, esophagectomy
or colectomy
; only the top rated hospitals for colectomy in the US News & World Report ratings had a statistically significant lower mortality than national averages—mortality rates at HealthGrades' best hospitals were not not significantly lower for any of the three procedures.
A similar study, published in Journal of the American College of Surgeons in 2010, compared mortality in US News and World Report and HealthGrades lists of "Best Hospitals" for abdominal aortic aneurysm repair, coronary artery bypass, aortic valve repair and mitral valve repair. Risk-adjusted mortality was found to be statistically significantly lower in the HealthGrades' "Best Hospitals" for coronary artery bypass and aortic valve repair.
lists multiple complaints from healthcare providers alleging inaccurate information and from consumers alleging credit card
charges for unwanted subscription services.
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
s, nursing home
Nursing home
A nursing home, convalescent home, skilled nursing unit , care home, rest home, or old people's home provides a type of care of residents: it is a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living...
s, physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s and dentist
Dentist
A dentist, also known as a 'dental surgeon', is a doctor that specializes in the diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aides in providing oral health services...
s. Quality ratings are devised from publicly available patient safety data and analyzed with proprietary technology developed by HealthGrades. In addition to these ratings, HealthGrades offers consulting services to health care providers to improve safety and enhance marketing and public relations.
Origins
The for-profit company, based in Denver, ColoradoDenver, Colorado
The City and County of Denver is the capital and the most populous city of the U.S. state of Colorado. Denver is a consolidated city-county, located in the South Platte River Valley on the western edge of the High Plains just east of the Front Range of the Rocky Mountains...
, was founded in 1999 by Kerry Hicks, who served as president and CEO of the predecessor Specialty Care Network from 1995 to 1999. HealthGrades grew steadily and in 2008, the company purchased Alijor, an internet company that gave health care providers the ability to display information about their business, including location(s), hours, insurance acceptance and credentials. Consumers could search the Ailjor site to find a health care provider that met their needs. Hicks grew HealthGrades into one of Colorado's largest public companies (formerly ) until Vestar Capital Partners
Vestar Capital Partners
Vestar Capital Partners is an American private equity firm focusing on leveraged buyout transactions in the United States, Europe and Asia.The firm, which was founded in 1988 is headquartered in New York City with offices in Boston, Massachusetts, Denver, Colorado in the US as well as Paris, Milan,...
acquired the company in 2010 and took the company private.
Ratings
Hospital ratings reports for specific procedures and diagnoses are compiled primarily from MedicareMedicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
claim data, and include all hospitals that are Medicare participants. Some critics insist that medical records should be used instead of claim records which do not include factors that affect patient outcomes. Ratings are updated yearly, but data is two years old before Medicare releases it. Therefore, the 2011 ratings are derived using data from 2007-2009.
HealthGrades develops objective ratings based on data and information obtained from several sources, mostly available to the public. The data is analyzed using a proprietary methodology that identifies the recipients of the various awards and the "1-3-5 Star" designation. Specifically, most ratings are determined from multivariate
Multivariate statistics
Multivariate statistics is a form of statistics encompassing the simultaneous observation and analysis of more than one statistical variable. The application of multivariate statistics is multivariate analysis...
logistic regression
Logistic regression
In statistics, logistic regression is used for prediction of the probability of occurrence of an event by fitting data to a logit function logistic curve. It is a generalized linear model used for binomial regression...
s of medical outcomes at a given healthcare provider and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively. The ratings have been criticized for oversights in the methodology that may actually penalize some institutions with ideal medical outcomes. Because HealthGrades' algorithms are proprietary, outside experts have "expressed concern about the reliability and validity of such 'black box' rating scales."
In addition to "Star" ratings, HealthGrades identifies facilities for their Top 10% in the Nation, Top 5% in the Nation, America's 50 Best Hospitals, Distinguished hospital award for Clinical Excellence, and Excellence Awards in 26 areas:
Outstanding patient experience, Patient safety, Pediatric patient safety, Women's health, Bariatric surgery, Cardiac care, Cardiac surgery, Critical care, Coronary intervention, Gastrointestinal care, Gastrointestinal surgery, General surgery, Gynecologic surgery, Heart transplant, Joint replacement, Kidney transplant, Liver transplant, Lung transplant, Maternity services, Orthopedic services, Prostatectomy, Pulmonary care, Spine surgery, Stroke care and Vascular surgery. Emergency medicine, HealthGrades newest rating area, was added in 2010.
Website
The company's online application, HealthGrades.com, provides ratings and cost information for 5,000 hospitals and 16,000 nursing homes. Extensive physician profiles are available for 750,000 physicians and 181,865 dentists. Web visitors can input their opinions in a survey based on their experience with an individual health care professional, and view provider ratings at no charge. Some comprehensive reports require payment of a fee. Time magazineTime (magazine)
Time is an American news magazine. A European edition is published from London. Time Europe covers the Middle East, Africa and, since 2003, Latin America. An Asian edition is based in Hong Kong...
listed the HealthGrades website as one of the 50 best on the internet for 2011. The site has 11 million unique visitors each month across all web properties. Many prominent companies and health plans make HealthGrades information available to their participants.
BetterMedicine.com is also a member of the HealthGrades company.
Licensing
Hospitals are HealthGrades biggest customers and provide the bulk of the company's income. Hospitals that are highly rated providers will license HealthGrades' ratings and trademarks to use in their marketing promotions. The company uses litigation to protect its' name and ratings. HealthGrades sued the Robert Wood Johnson University HospitalRobert Wood Johnson University Hospital
Robert Wood Johnson University Hospital is the clinical campus of the Robert Wood Johnson Medical School in New Brunswick, New Jersey. It provides a full range of health care services as Central New Jersey's only Level 1 Trauma and academic medical center. The hospital is a member of the Robert...
in 2006 for copyright and trademark infringement after the hospital used HealthGrade's ratings and logo in promotional publications without paying licensing fees.
Consulting
HealthGrades provides consulting services to more than 350 hospitals for recommendations on how to preserve or improve their quality of care, as well as marketing and business development.Independent evaluation
Medical experts have questioned the reliability of the 1-, 3- and 5-star ratings given to healthcare providers, criticizing the lack of transparency and perceived oversights in HealthGrades' methodology.A 2004 report in the Rocky Mountain News
Rocky Mountain News
The Rocky Mountain News was a daily newspaper published in Denver, Colorado, United States from April 23, 1859, until February 27, 2009. It was owned by the E. W. Scripps Company from 1926 until its closing. As of March 2006, the Monday-Friday circulation was 255,427...
concluded that HealthGrades had inaccurate physician disciplinary records (while competitor ChoicePoint
ChoicePoint
ChoicePoint was a data aggregation company based in Alpharetta, near Atlanta, Georgia, United States, that acted as a private intelligence service to government and industry...
had much greater accuracy). The report also detailed the complaints of former HealthGrades employees and physicians that pursued legal actions after inaccurate reports.
A 2002 study published in JAMA
Jama
Jama or JAMA may refer to:* Jama Software, a privately held company in Portland, Oregon* Journal of the American Medical Association, an international peer-reviewed general medical journal...
reported that HealthGrades ratings for mortality
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...
associated with acute myocardial infarction identified "groups of hospitals differing in the aggregate in quality of care and outcomes" but heterogeneity within the ratings for individual hospitals could not reliably discriminate between individual hospitals in quality of care or mortality. To illustrate: for any pair of hospitals rated to two different rating groups (1-, 3- or 5-star) by HealthGrades, the researchers determined that standardized mortality rate
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...
s were "comparable or even better in the lower-rated hospital in more than 90% of the comparisons".
A 2011 study published in Archives of Surgery
Archives of Surgery
The Archives of Surgery is a monthly professional medical journal published by the American Medical Association. Archives of Surgery publishes original, peer-reviewed clinical and basic research articles addressing new operative techniques, important clinical findings, and real-life lessons from...
evaluated HealthGrades and US News & World Report ratings in oncologic surgeries
Surgical oncology
Surgical oncology is the branch of surgery which focuses on the surgical management of cancer.The specialty of surgical oncology has evolved in steps similar to medical oncology, which grew out of hematology, and radiation oncology, which grew out of radiology...
, comparing top-rated hospitals in the two reports to all other U.S. hospitals. The authors determined that both ratings systems had substantive flaws in the evaluation of mortality following pancreatectomy
Pancreatectomy
In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. Several types of pancreatectomy exist, including pancreaticoduodenectomy , distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy...
, esophagectomy
Esophagectomy
Esophagectomy or Oesophagectomy is the surgical removal of all or part of the esophagus .-Purpose:...
or colectomy
Colectomy
Colectomy consists of the surgical resection of any extent of the large intestine .-History:Sir William Arbuthnot-Lane was one of the early proponents of the usefulness of total colectomies, although his overuse of the procedure called the wisdom of the surgery into question.-Indications:Some of...
; only the top rated hospitals for colectomy in the US News & World Report ratings had a statistically significant lower mortality than national averages—mortality rates at HealthGrades' best hospitals were not not significantly lower for any of the three procedures.
A similar study, published in Journal of the American College of Surgeons in 2010, compared mortality in US News and World Report and HealthGrades lists of "Best Hospitals" for abdominal aortic aneurysm repair, coronary artery bypass, aortic valve repair and mitral valve repair. Risk-adjusted mortality was found to be statistically significantly lower in the HealthGrades' "Best Hospitals" for coronary artery bypass and aortic valve repair.
Criticism
HealthGrades has been criticized for its use of "automatic renewal" subscription charges to customers that purchase reports. ConsumerAffairs.comConsumerAffairs.com
ConsumerAffairs.com is a consumer advocacy and complaints site that defines itself as an “independent consumer news center”.The site publishes original and reprinted stories on consumer-related topics....
lists multiple complaints from healthcare providers alleging inaccurate information and from consumers alleging credit card
Credit card
A credit card is a small plastic card issued to users as a system of payment. It allows its holder to buy goods and services based on the holder's promise to pay for these goods and services...
charges for unwanted subscription services.