New York – like the rest of the nation – spends enormous amounts of money on health care. Yet states’ health care spending varies greatly. According to the most recent data provided by the federal government, per capita personal health care spending ranged from $7,522 in Utah to $14,007 in New York. Per capita spending in New York State was 37 percent higher than the national average ($10,191).
When it comes to spending on health care provided by hospitals, New York spends the second most, behind only California. Some of that spending is, of course, the result of more generous coverage benefits, but a second set of federal data about the quality of the care offered by New York hospitals raises some troubling questions.
The U.S. Department of Health and Human Services publishes Medicare.gov/Hospital Compare, which reports the quality of the nation’s hospitals to the public. It gives each hospital one, two, three, four, or five quality stars, with one-star hospitals being the worst and five-star hospitals the best. The overall rating summarizes a variety of measures across 5 areas of quality into a single star rating for each hospital. (The 5 measures are mortality, safety of care, readmission rates, patient experience, and timely and effective care.)
According to the Centers for Medicare & Medicaid Services (CMS), the Hospital Care Compare is a consumer-oriented website that provides information on the quality-of-care hospitals are providing to their patients. This information can help consumers make informed decisions about health care. Hospital Care Compare allows consumers to select multiple hospitals and directly compare performance measure information related to heart attack, emergency department care, preventive care, and other conditions.
According to the Hospital Care Compare about 15 percent of the nation’s 4,654 star-rated hospitals earned five-star status.
Here in New York, of the 194 hospitals, only 11 (5.7%) received a 5-star rating. 19 received a 4-star rating, 35 received 3 stars, 48 received 2 stars, and 25 received a 1-star rating – meaning that they provide the worst quality of care, according to the feds. Interestingly, 56 hospitals were reported in the “not available” category, which presumably means that they provided insufficient information to be ranked.
Why does this matter? Poor quality care is not only a waste of money, but it can also have devastating consequences for patients. The costs of substandard care are well-documented. In November 1999 the Institute of Medicine report, To Err is Human: Building a Safer Health System, was released. It documented a veritable epidemic of preventable deaths in United States hospitals. In September 2009, the director of the US Agency for Healthcare Research and Quality, wrote this about To Err Is Human: “Let me be clear: I am just as frustrated as my colleagues in the public and private sectors with our slow rate of progress in preventing and reducing medical errors.” Then in 2013, a widely-covered study published in the Journal of Patient Safety reported that nearly 400,000 U.S. hospital patient deaths each year were preventable.
The CMS star ranking illustrates problems in hospital care in New York. According to experts, New York’s hospital care ranks poorly when compared to the rest of the nation.
The national think tank, the Leapfrog Group, issued a report this year looking at hospitals’ quality of care nationwide. Unfortunately, the Leapfrog Group found that New York State ranked 37th nationwide in terms of quality, with only 11 percent of hospitals receiving an “A” grade according to their ranking.
Why do New York hospitals perform comparatively so much worse? In July 2019 the director of Leapfrog Group, explained what she knew about New York’s hospital safety:
“The system as a whole didn’t seem to have emphasized safety. We’ve seen other states work together and look at what’s working well at other states and implement it. It just doesn’t seem to be happening in New York. It has to be front of mind every single day in a hospital.”
These analyses raise serious questions for New York’s new Health Commissioner, such as why did New York State hospitals rank so poorly? What has the New York Department of Health done to respond to the national rankings that have consistently found poor quality in state hospitals?
Meaningful responses to those questions will help ensure that New York patients – and taxpayers – are being protected. The toll in taxpayer dollars and human lives is too great for these not to be front-burner questions.