If anybody needs more evidence that the consumer movement is gaining traction in health care, the stricter standards for the government’s Nursing Home Compare website are pretty convincing.
Earlier this month, the Centers for Medicare & Medicaid Services announced it was making it more difficult for nursing homes to earn the highest grades on the report card, which is used by nearly 1.5 million Americans to compare care at about 15,000 sites. Patient advocates had charged that the measures were too easy to meet and that some undeserving facilities were earning four or even the maximum five stars.
As Julie Appleby reported in Kaiser Health News, Nursing Home Compare has always based its ratings on such quality measures as the percentage of patients who develop bed sores or are injured in falls. Among the new measures: the percentage of patients given antipsychotic drugs — which was added in response to the fear by some families that patients are being medicated inappropriately to make them easier to manage.
After the tougher measures went into effect, the impact was immediate. Previously, about 80 percent of nursing homes received a four- or five-star rating; after the change, that percentage fell to nearly half. The number of homes receiving one star increased to 13 percent from 8.5 percent.
The CMS move is another step toward empowering Americans to better understand their health care options — including whom they want to provide it. As H&HN’s February cover story notes, high-deductible health plans are forcing consumers to take more control of their medical spending. That, in turn, is prompting them to comparison shop for physicians, hospitals and every other type of provider. They’re largely basing their decisions on transparent pricing, quality ratings and customer service.
In other words, shopping for health care is starting to look a lot like shopping for other commodities and services.
Hospitals around the country are adjusting to this new reality. Quality ratings are proliferating, as are Yelp-type websites that let the public review their experiences with certain providers. Some providers are posting prices online. Some are dramatically reducing the time it takes to get an appointment and the wait time once the patient arrives. Others are experimenting with a whole slew of tactics to make themselves more attractive to the new health care consumer. Lola Butcher examines the range of creative solutions in her cover story, “Consumerism Hits Health Care,” the first in H&HN’s yearlong series on the topic.