What is the purpose of this website?
This website, developed by the Massachusetts Health
Care Quality and Cost Council is a tool to help you learn about the patient
safety, health care quality, and cost of care provided by Massachusetts hospitals.
Selecting the right hospital for the treatment you need is an important decision.
These independent comparisons of hospitals and of other health care providers are meant to be used along with talking
to your doctor so together you can choose the care that best suits your needs. top of page
What can I find on this website?
The quality and cost of health care varies by provider. This website provides an
independent comparison of patient safety, quality, and cost of care provided by
Massachusetts hospitals and providers. You can find providers in your area; compare cost,
quality and patient safety by location, procedure or condition; or view the ratings
of a particular provider. Talk to you doctor and use this information to select
the provider that best suits your needs.
This website can help whether you have had health insurance for many years, are
newly insured, or pay for your care out of your own pocket. You can use it to answer
questions such as:
- My doctor sees patients at two different hospitals or clinics, which one should I choose?
- How does care at my local hospital compare to the care at a large medical center?
- How does this hospital or clinic compare to others for the procedure I need?
- How does the price of care compare at different providers?
- I just moved here. Where can I find the best health care?
Information comes from state and federal databases as well as other trusted sources.
The data ratings are updated on a regular basis.
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How do I compare providers on the website?
1) You can select the type of provider (for example, “hospital” or “medical group”)
as appropriate for your request.
2) If you want to search by location, in the “Your Location” search box, type your
city, zip code or county. Choose the distance you are willing to travel. Use “all”
if you want to see all providers of that type in the state. Finally, click on “FIND”.
3) The next page “Search Results” will show a list of providers that meet your location
and distance selections. If you find no providers, or the provider of interest is
not on the list click on the Start A New Search button and check your spelling or
zip code. You may need to increase the miles you are willing to travel to find providers.
You can select up to 4 providers by moving the cursor over to the check boxes on
the far right of the list. Now, click the blue “Compare” button at the top or bottom
of the column of check boxes.
4) The next page (Comparison of Providers) shows the Patient Safety ratings for
each provider selected. To review comparisons of any other condition or procedure,
move your cursor over to the left hand margin and click on that condition or procedure,
such as heart attack. You will then see a comparison of available quality and cost
data for those providers for that condition or procedure.
To look at details, click on the “View Detailed Report” tab. To return to the summary
page, click on the “Summarized Report” tab.
5) If you click on the name of a provider, you will see an “About the Provider”
page to learn more about the provider. Then you can move your cursor over to the
left hand margin and click on any condition or procedure.
6) You can search for a single provider by clicking on the “Health Care Provider”
tab on the home page, or search by condition or procedure by clicking on the “Medical
Condition or Procedure” tab. top of page
How is hospital quality measured?
This website shows widely used quality measures that were created by established
national organizations. This website shows different types of quality measures,
including:
- Patient Safety. This measure describes ways a hospital can help reduce patient
care errors. Higher scores are better. Some, but not all of the measures are Patient
Safety (Steps to Avoid Harm), using computers to order medications, tests and procedures,
staffing the ICU with doctors who have specialized critical care training, managing
serious events, and reducing infections.
- Mortality. This refers to the number of patients who die during their hospital
stay. A lower mortality rate means that fewer patients died.
- Recommended Care. These refer to specific and proven ways that hospitals
can help patients who have a specific condition. A higher rate means that hospitals
give this care to more patients
- Patient Experience. This refers to what patients say about their hospital
experience in surveys.
Given that some hospitals treat more seriously ill people than others, the results
are adjusted for severity of illness (how sick a patient is) to provide a more meaningful
comparison. Only hospitals that have treated more than 30 patients a year for the
specific procedure or condition are available for comparisons.
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Is there any information on hospital readmissions?
Hospital Readmissions are when patients who have had a recent hospital stay need to go back
into a hospital shortly after their discharges. The 30-day readmission rates for heart attack,
heart failure, and pneumonia are displayed under the specific condition. This data is from CMS
Hospital Compare for patients 65 years and older on original Medicare.
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Why is statistical significance for Medical Groups different on the MHQP website?
The MHQP rating system uses a 4-star rating methodology that does not use statistical significance
test when comparing the medical group’s rate with the benchmarks. 1 star means the rate is not above
benchmarks; 2 stars means the rate is above one benchmark; 3 stars means the rate is above two
benchmarks; and 4 stars means the rate is above three benchmarks. The three benchmarks used for
comparison are: the MHQP Massachusetts Statewide Rate, the National 90th Percentile, and the National
Average.
A majority of the quality measures on MHCO are reported with a 3 star rating system: below
the state’s average, not different than the state’s average and better than the state’s average.
This is a valid approach to differentiate hospitals’ and in this case, medical groups’ performance
on specified quality measures. The 3-star rating methodology does use statistical significance test.
For each measure, the medical group’s rate is calculated based on a “numerator” that represents
the number of people who actually received a recommended healthcare service divided by a “denominator”
that represents the number of people who should have received that healthcare service. Ninety-five
percent confidence intervals are calculated for each medical group’s rate.
The benchmark used for comparison is the MHQP Massachusetts Statewide Rate, which is defined as
the sum of all numerators across medical groups divided by the sum of all denominators across all
medical groups. If the statewide rate falls in between lower and upper bounds of the confidence
interval of the medical group’s rate, then the medical group is not statistically different from
the statewide average; if the statewide rate is above upper bound of the confidence interval, then
the medical group is statistically lower than statewide average; and if the statewide rate is lower
than lower bound of the confidence interval then the medical group is statistically higher than
statewide average. top of page
What is statistical significance for quality for hospitals?
Statistical Significance is a mathematic test used to determine whether a hospital’s
performance (better or worse) is measurably different from the statewide average,
and that the difference is not due to chance.
Statistical significance depends, in part, on the number of patients a hospital
treats. For a hospital with a small number of cases, it is harder to be sure that
the hospital performs better or worse than average. For a hospital with more cases,
it is easier to be sure that it performs better or worse than average.
Statistical Significance is shown as:
-
Above State Average Quality. We are 95% sure that the hospital performs better
than state average quality
-
Not Different from State Average Quality. The hospital performs in the average
or as expected range.
-
Below State Average Quality. We are 95% sure that the hospital performs worse
than state average quality. top of page
How is hospital cost measured?
Cost is based on the actual amounts that health plans paid hospitals for treating
a specific condition or performing a procedure. The patient’s share of this cost
depends on the patient’s insurance plan. The website shows median dollar amounts,
meaning that half of the cases at this hospital cost more and half cost less. Inpatient
costs are adjusted for severity of illness (how sick patients are) to provide a
more meaningful comparison. The cost shown does not include the price that health
plans pay to doctors. Together, cost and quality measures can help patients decide
where to get care. It is important to know about quality and cost no matter whether
you or your health plan pays for your care.
Costs can vary a lot. Sometimes this happens even when patients are treated at the
same hospital, by the same doctor, for the same condition. Costs may be very different
than the specified cost (higher or lower) depending on the specific services you
receive
Ratings
- Above Median State Cost: We are 95% sure that the hospital cost is above median
state cost. The rating for such a hospital measure is three dollar signs
(
).
- Not Different from Median State Cost: We are 95% sure that the hospital’s cost is
not different from the median state cost. The rating for such a hospital measure
will be two dollar signs
(
).
- Below Median State Cost: We are 95% sure that the hospital’s cost is below the median
state cost. The rating for such a hospital measure will be one dollar sign
().
The website also provides a detail page with information about the range of costs
for a particular service:
- High cost (85th percentile). 85% of patients who had this service at this
hospital had a cost less than this amount. This is at the higher end of the cost
range.
- Median cost. Half of those patients who had this service at this hospital
cost more than this and half cost less than this amount.
- Low cost (15th percentile). 15% of patients who had this service at this
hospital had a cost less than this amount. This is at the lower end of the cost range.
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What is statistical significance for cost?
Statistical Significance is a mathematic test used to determine whether a hospital’s
cost (higher or lower) is measurably different from the statewide cost, and that
the difference is not due to chance.
Statistical significance depends, in part, on the number of patients a hospital
treats. For a hospital with a small number of cases, it is harder to be sure that
the hospital’s cost is higher or lower than the statewide median cost. For a hospital
with more cases, it is easier to be sure that its cost is higher or lower than the
statewide median cost.
Statistical Significance is shown as:
- Above Median State Cost: We are 95% sure that the hospital cost is above
median state cost. The rating for such a hospital measure is three dollar signs
(
).
- Not Different from Median State Cost:We are 95% sure that the hospital’s
cost is not different from the median state cost. The rating for such a hospital
measure will be two dollar signs
(
).
- Below Median State Cost:We are 95% sure that the hospital’s cost is below
the median state cost. The rating for such a hospital measure will be one dollar
sign
().
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When I compare the hospital cost to the statewide median, the result suggests the
rating should be different. Is the rating correct?
Dollar sign ratings are assigned based on the statistical significance of the cost
comparison. Statistical significance measures how certain we are that the difference
between the hospital’s cost and the statewide median is mathematically important.
The rating is based on a comparison of the unrounded values for each hospital to
the statewide median. After the statistical significance and the dollar sign ratings
are calculated, the cost numbers are rounded and then reported on the website. In
some cases, the rounding process results in reporting values that may appear inconsistent
with the statistical significance.
If a value is under or equal to $100, it is rounded up or down to the nearest $10.
If a cost is between $101 and $1000, it is rounded up or down to the nearest $25.
If a cost is between $1,001 and $10,000, it is rounded up or down to the nearest
$100. And if a cost is over $10,000, it is rounded up or down to the nearest $500.
For example, if the statewide value is $120 and a hospital’s particular cost is
$130, both will be rounded to $125. The statistical significance test which compares
the hospital cost of $130 to the statewide value of $120 could indicate that that
the hospital is “no different than the median state cost” or the test could show
that the hospital is “above the median state cost.” The statistical test result
is affected by the number of observations (the sample size) and the range of variation
within the sample.
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My health plan pays for my care. Why is cost important?
Costs can vary a lot. A higher cost does not mean better quality of care. Cost is
based on the actual price that health plans pay hospitals for treating a specific
condition or performing a procedure, and is NOT what a patient will pay. Your actual
costs will be different and will depend on your health insurance plan.
When your health plan pays for your hospital care, it uses dollars you, other members,
and your employer pay in premiums. This website will help you understand what your
premium dollars pay for. It is important to know about quality and cost no matter
whether you or your health plan pays for your care.
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Why is cost different for the same service at different hospitals?
This website shows cost based on the actual price that health plans pay hospitals.
Health plans may agree to pay a different rate at different hospitals based on many
different factors. For example:
- Wage levels and prices of goods and services in the area
- The number of nurses and other staff per patient
- The number of new doctors and medical students the hospital trains
- The cost of capital equipment and new technology
- Patients’ severity of illness (how sick patients are)
- Other factors important to the health plan or the hospital
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What is the Massachusetts Health Care Cost and Quality Council (Council)?
The Massachusetts Health Care Quality and Cost Council (Council) was established
as part of the 2006 Massachusetts Health Reform Law to establish statewide goals
for improving health care quality, containing health care costs, and reducing racial
and ethnic disparities in health care. The Council has the mandate to develop and
maintain a consumer-friendly website of comparative health care cost, quality, and
patient safety for consumers, health care providers, health plans, employers, and
policy-makers. An active Advisory Committee offers advice and feedback. Its members
include consumers as well as representatives from business, labor, health care providers,
and health plans. To learn more about Council, go to the About
Us tab. top of page
When and where is the next Council Meeting?
The schedule of meetings for the Council and its subcommittees can be found on the
Council’s website (www.mass.gov/healthcare).
On the lower right hand side of the home page, click on “Meeting Agendas and Minutes.”
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How can I contact a particular member of the Council?
Please click here to go to the about us page to obtain email and phone information for the Council. top of page
Where can I get information on health insurance?
The Commonwealth Care Connector has information on subsidized and affordable health
insurance plans for income eligible MA residents. Connector staff can also refer
you to other health care options such as MassHealth and the Health Safety Net depending
upon your individual circumstances. The telephone number to call is 1-877-MA-ENROLL
(1-877-623-6765) or go to
www.mahealthconnector.org top of page
I am a consumer and have questions regarding my health care, whom should I contact?
|
Question about my insurance company |
Call the Department of Public Health Office of Patient Protection (OPP) at
1-800-436-7757 |
|
Questions about a bill from a hospital or provider
|
Call the Division of Health Care Finance and Policy at
1-800-609-7232 |
|
Questions about the care received at a hospital or nursing facility |
Refer to Department of Public Health Division of Health Care Quality
(617) 753-8000 |
|
Employer Fair Share Questions |
Call the Division of Health Care Finance and Policy at
1-800-609-7232 |
Questions about your personal health care?
We regret that we cannot investigate your specific complaint about an insurance
company or a health care provider and recommend that you contact the following offices
for further assistance:
- If you have a concern about your insurance company, please call/email the Division
of Insurance Managed Care Bureau at : 1-617-521-7794 or
DOICSS.Mailbox@state.ma.us.
- If you have a concern about your physician, please call/email them directly.
- If you have a concern about a hospital, please call/email them.
- If you have a concern about a nursing home, please call/email them.
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