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Abstract:
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Publicly available provider profiles report healthcare quality metrics to providers and patients. These profiles have become increasingly available through resources such as the Centers for Medicare and Medicaid Services’ Compare websites, ProPublica’s Surgeon Scorecard, and US News & World Report’s annual ranking and rating of hospitals. While these resources are available, there is no one size fits all approach to profiling, and the methodologic decisions to be made often depend on the condition or procedure being profiled as well as the data that are available. While there is some evidence that quality measurement and reporting may fuel a feedback loop that then improves outcomes, low-volume hospitals – the hospitals that routinely are estimated to provide the lowest quality of care and have the poorest outcomes -- are routinely excluded from measurement and reporting. Often, different thresholds are used to define low-volume. We evaluate and compare various approaches for assessing performance of providers with low-volume providers to obtaining risk estimates.
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