Medicare gives UMass Memorial lowest quality ranking

Write a Comment

By Laura Finaldi

Acute care hospitals in Central Massachusetts received moderate to low rankings on a five-star hospital ranking system put out by the federal government.

Medicare.gov late last month released Hospital Compare five-star ratings, ranking U.S. hospitals based on 64 quality measures and seven areas of quality. Most acute care hospitals in the region, including Saint Vincent Hospital, got three out of five stars. However, UMass Memorial Medical Center in Worcester, by far the region’s largest hospital with 779 beds, got just one star.

The rankings analyzed seven areas of quality, including patients’ experiences, timeliness and effectiveness of care, complications, payment and value of care, readmissions and death, and efficient use of medical imaging. Data for some hospitals was available for as few as nine of the 64 quality measures.

The rankings were widely panned statewide. Hospitals receiving low marks criticized the rankings, saying they effectively compared apples to oranges.

“The ratings disadvantage hospitals that care for the sickest patients, especially those that take patients as emergent transfers, and favor small niche hospitals that take care of a narrow population of patients primarily through planned admissions,” UMass Memorial Health Care CEO Eric Dickson wrote on his blog.

According to the rankings, UMass Memorial’s percentage of 30-day hospital readmissions was greater than the national rate of 15.6 percent, but 30-day readmissions or deaths for several specific medical conditions -- like heart attacks and pneumonia -- were about the same as the national standard. UMass Memorial had comparatively low mortality rates within 30 days of patients receiving treatment for certain medical conditions, including heart failure. At Saint Vincent Hospital, the region’s second largest medical center with 321 beds, readmissions across the board occurred at similar rates to other hospitals across the U.S.

The two hospitals, both of which have very high emergency room volume, according to the rankings, had longer emergency room wait times than other very high volume hospitals in the U.S. Patients in Saint Vincent’s emergency room, and at MetroWest Medical Center in Framingham (the region's third largest hospital) waited 39 minutes on average to be seen by a healthcare professional, compared to 45 minutes at other hospitals in Massachusetts and 32 minutes at other U.S. hospitals. The same wait time at UMass Memorial was 67 minutes, according to the rankings.

UMass Memorial spokesman Anthony Berry said that the hospital is opening a new 23-bed unit next month to address emergency room overcrowding.

Saint Vincent received three out of five stars for its patient experience ranking, the results for which were tallied from a survey. Patients reported being given information about what to do during at home recovery more frequently than other patients did at different hospitals across the state and the country, but reported confusion around their post-hospital care more frequently than patients at other hospitals did.

Erica Noonan, a spokeswoman for Saint Vincent, said it is important to note that no single rating system provides a complete portrait of care at a hospital.

“Saint Vincent regularly evaluates our patient care processes and have a number of initiatives in place to help us continually improve and enhance the quality and safety of our care,” Noonan said. “We are focused on continual improvement, and we use publicly available data, coupled with our comprehensive internal data, to evaluate and improve our performance.”

Overall, larger hospitals ranked lower overall on the list than their smaller counterparts. Hospitals with 200 or more beds received an average overall star rating of 2.81 stars, while hospitals with 100-199 beds received 2.96. Smaller hospitals with under 100 beds averaged 3.29 stars on the list, according to the Centers for Medicare & Medicaid Services.

Teaching hospitals, which include UMass Memorial and Saint Vincent, also fared poorly on average -- at 2.87 stars compared to 3.11 for non-teaching hospitals.