UnitedHealthcare Releases Its First-Ever Report Card on Hospital Quality and Affordability

UnitedHealthcare, the health plan subsidiary of UnitedHealth Group, has released its first-ever report card that rates quality of care and affordability among 20 of its contracted hospitals throughout Colorado.

The report rates the hospitals by measuring 150 medical procedures, including colon surgery, treatment of pneumonia, viral infection and chest pain, cesarean section, disc surgery, knee and hip replacement, and obesity procedures. Each procedure’s quality rating is based on patient volume, complication and mortality rates, failure to rescue or death from complications, ICU physician staffing, and computer-assisted order entry.

“As quality and cost variation in the health care system continues to increase, especially among hospitals, practicing physicians need resources and tools to make more informed decisions for their patients,” said Jay Ogsbury, M.D., a neurosurgeon and co-medical director of Colorado Preferred Physician Organization. “The information included in UnitedHealthcare’s Hospital Report Card is a great first step in making health care quality and cost more transparent for the physician community.”

The initial method of measurement is based on criteria established by the Agency for Healthcare Research and Quality and The Leapfrog Group, with data provided by Medicare and the Colorado Department of Health Services. The report cards are being shared with UnitedHealthcare’s contracted physicians.

Quality designations are represented by stars: one star for a facility rated among the lowest 25 percent, two stars for a facility rated among the middle 50 percent, and three stars for a facility scoring among the highest 25 percent. A hospital must have at least 20 cases for any particular procedure in order to be assigned a quality designation.

The cost evaluation is derived using paid-claims data received by UnitedHealthcare over the past 18 months. The claims data is case-mix and severity-adjusted to normalize average cost for comparison purposes.

“Programs that create transparency in quality and cost for health care services are part of UnitedHealthcare’s ongoing commitment to provide access to affordable, quality health care,” said Craig Keyes, M.D., chief executive officer of UnitedHealthcare of Colorado. “In light of the wide variation in quality and cost among hospitals, we’ve created an innovative, easy-to-use report card that we believe our contracted physicians and hospitals will find valuable in ensuring that their patients have access to the best care possible.”

Jeff Selberg, chief executive officer of Exempla Healthcare and current Chair of Colorado Hospital Association, said: “Exempla Healthcare is committed to providing the safest, highest-quality health care. We are working diligently to enhance our processes and systems to ensure that the information available to the public accurately reflects the quality of care we provide. We are pleased to see that Exempla Healthcare’s continued efforts to improve patient care and service have earned multiple quality designations and that UnitedHealthcare has ranked Exempla Healthcare as one of the highest-quality and most cost-effective hospitals in Colorado.”

“A 1999 report by the Institute of Medicine, which estimated that between 44,000 and 98,000 Americans die each year as a result of medical errors, underscores how important it is to improve accountability in the health care delivery system,” added Keyes. “In addition, we feel that the report can help promote the learning and adoption of best practices among our network hospitals and offer an incentive for our providers to continuously improve their performance to the benefit of our members.”