Some hospital rankings have come out recently and our own Mercy Jefferson fared poorly. I’d like to take a look at these rankings, along with some from last year, and then delve into some potential explanations.
Under Medicare, “the majority of the nation’s hospitals are being penalized by Medicare for having patients frequently return within a month of discharge,” reports the Post-Dispatch. Here’s a table of penalties assessed to local hospitals. Here’s the top of that table:
The penalty number is a percent reduction in payments per Medicare patient stay, with the maximum penalty being 3%. According to the article, “the fines are based on readmissions between July 2011 and June 2014 and include Medicare patients who were originally hospitalized for one of five conditions: heart attack, heart failure, pneumonia, chronic lung problems or elective hip or knee replacements.”
This is actually an improvement from last year, when Mercy Jefferson was penalized at 2.08%, the highest penalty in the area. This year, as you see, St. Anthony’s, the other hospital closest to most JeffCo residents, took over the top spot in the list. St. Clare in Fenton only received a 0.02% penalty this year.
In April, the federal government released its first “star ratings” for hospitals based on patient appraisals. Mercy Jefferson was one of four hospitals in the area to receive 2 stars out of 5 (St. Anthony was another); the lowest rating in the region. St. Clare got 4 stars.
According to the Post-Dispatch article, “Medicare’s new summary star rating…is based on 11 facets of patient experience, including how well doctors and nurses communicated, how well patients believed their pain was addressed, and whether they would recommend the hospital to others.”
Why the Low Rankings?
Here’s what Mercy Jefferson spokesperson and Leader columnist John Winkelman said last year about the Medicare penalties:
“We have seen our readmission rates improve since Jefferson joined Mercy. In an effort to continue to reduce readmission rates, we have improved processes and invested significant resources, including a new Electronic Medical Record system in March 2014. The 30-month data period used to define these readmission rates includes only five months of data since Jefferson joined Mercy.
“Mercy Jefferson serves patients from a seven-county region including many areas underserved by primary physicians. Patients often delay seeking care or following up because of limited access. The region served by Mercy Jefferson also includes a patient population that is older than other areas of the region, with rates of tobacco use, obesity, and diabetes higher than state averages.”
So there are potential demographic explanations. The article on 2015 penalties says:
“Hospitals have been lobbying both Medicare and Congress to take into account the socioeconomic background of patients when assessing readmission penalties. They argue that some factors for readmissions — such as whether patients can afford medications or healthy food — are beyond their control.”
I would imagine, though, that Christian Hospital in north St. Louis does not have the best demographics, and they got 3 stars and a o.82% penalty.
Mercy took over Jefferson Regional Medical Center in 2013. Mercy is probably having to institute some changes to professionalize the formerly independent hospital, and that may take some time.
We will have to watch future rankings to see if there is improvement at Mercy Jefferson. This year’s Medicare penalties are based on data that is over a year old, so they don’t reflect the most recent performance (good or bad). There are other rankings out there, too, like Google reviews, where Mercy Jefferson gets a 3.9 out of 5, but based on only 7 reviews. So we should consider those, too. One may want to consider these rankings next time the need to visit the hospital arises.