Government to Rate Medicare Provider Quality

The federal government is planning for the first time to issue detailed ratings of the quality of care provided by nursing homes, Medicare health plans, dialysis centers and eventually hospitals and doctors, a senior Bush administration official announced Monday.

The Health Care Financing Administration, using newspaper advertisements, the Internet and toll-free telephone numbers, plans to release numerical scores for every Medicare provider four times a year based on a half-dozen criteria, ranging from medical credentials to staffing levels.

Relying on both government inspection reports and customer surveys, the plan would provide the most comprehensive, objective way to evaluate health care providers, going far beyond the limited information available to consumers.

“Collecting data and publishing it changes behavior faster than anything else,” Thomas Scully said Monday in his first speech as head of the agency that oversees Medicaid and Medicare.

Similar to the publishing of automobile crash test data, the plan has far-reaching implications for millions of Americans, and for an industry that has been slow to adopt standardized quality measurements.

Proponents say scorecards will help give consumers the power to aggressively shop for health care. Even more significantly, consumer-friendly, numerical ratings appear to be the best way to force the health care industry to raise its standards.

“There is a lot of evidence that the people who use this type of information the most are providers,” said Nancy-Ann DeParle, former head of the health care administration. “They look to see how they are doing versus other providers.”

Representatives of health care groups, however, questioned the plan, saying the government’s data could be misleading because it fails to take into consideration factors such as whether facilities treat a sicker patient population. For such reasons, groups representing doctors, hospitals and other health care providers have long opposed the release of such ratings.

The federal government spends about $300 million a year collecting information on the thousands of health care providers that serve the 70 million people in Medicare and Medicaid.