3-1 Activity: Hospital Comparison Assignment

Roy George Thundathil

SNHU

IHP-610-Q2473 Health Policy and Law 23TW2

Dr. Marcy Adams

December 24, 2023

 The two hospitals I decided to compare for acute care are Methodist Medical Center and

Saint Francis Medical Center in Peoria, IL. I decided on these hospitals because they are very

close to each other and me. I'm very familiar with both of these hospitals because they are in my

hometown, and I have lived here for over 48 years.

Analysis of patient survey

The results of patient surveys can help give positive change and improve the quality of

institutions that deliver health care. This will identify the patient's needs and wants. (Zgierska et

al.2014). Over a billion dollars are often withheld from hospitals annually because they cannot

maintain the basic standards and care that patients must have. If patient surveys are high, the

hospitals can earn money back. About 30% of hospitals, Medicare, and reimbursement are based

on assessments. (How policies impact hospitals, patients and health care workers, 2019)

The hospital consumer assessment of healthcare providers and systems has a 32-question

survey that patients can fill out, which is given by CMS to measure their overall satisfaction with

their hospital state. This survey will help the hospitals understand why they cannot score at the

top or bottom. If they score at the bottom, they lose their income. (How hospital policies impact

patient and health care workers, 2019)

The private insurance reimbursement is affected by this survey. Most of the

reimbursements are from repeated patient visits and whether or not they're more likely to return

to the hospital if they had a good experience. If the hospital has a poor survey, patients will not

likely return and will see diminished reimbursement from private insurance. (Strate,2022).

Patient evaluation is a valuable tool that allows them to have an opportunity to improve, make

better strategic decisions, reduce costs, monitor healthcare performance, and set standards and
benchmarks for the hospitals. (Al-Arbi & Al-Balushi,2014). This survey is a valuable tool that

helps the patients be involved in the decision-making and improving health care quality. The

survey is a handy tool to evaluate the hospital. There will be a lot of difficulties among the

lower-income populations participating in the study because of their low educational levels.

Also, pediatric and psychiatric patients are not allowed to take the survey, which is not designed

to address their situations. This is very sad because they cannot be represented in the study, and

their voices will not be heard.

Saint Francis Medical Center has a survey response rate of 24%, and Methodist Medical

Center has a survey response rate of 20%. Saint Francis Medical Center had a nurse

communication rate of 76%, and Methodist Medical Center had 73%. The national average is

79%, and the Illinois average is 78%. The doctor communication rate was 75% at Saint Francis

and 72% at Methodist Medical Center. The national average was 79%, and the Illinois average

was 78%. 67% of others would recommend Saint Francis Medical Center and 63% would

recommend Methodist Medical Center. The national average was 69%, and the Illinois average

was 66%.

Even though both hospitals are acute, they do not have much information regarding underserved

and vulnerable populations because they are not involved in the survey. This population is

significant, especially in Peoria, IL. This population needs a lot more medical attention and

should not be overlooked. If these individuals are not included in the survey, they will show

many gaps in the system that need to be fixed.

Analysis of complication and death rate

 The public needs to report the complications of death rates in a hospital because this will

increase the quality of care and will be more transparent. The transparency lets us know the cases

and patients and what information is needed when going to that hospital. Patients are less likely

to go to a hospital where they have a higher percentage of complications of death because there

will be less insurance reimbursement. When hospitals are transparent, it allows them to improve

their quality of care and enable patients to return to their hospital. This also allows the hospital to

maintain its standards so it doesn't lose its reputation. Saint Francis Medical Center has a death

rate of 163.26, and Methodist Medical Center has 156.30. The national result is 143.04. In 2012,

the CMS began reducing Medicare payments for readmissions. The CMS calculates payment

production for hospitals based on their performance periods. Private insurance companies take

the same approach due to the complications of death rates. Suppose the combination of death or

complication rate allows the hospital's value of care to be judged. It is essential to improve the

value of care by reducing hospital care costs and improving the quality of care. (Centers for

Medicare and Medicaid Services, n.d).

Analysis of Unplanned Hospital Visit Ratings

A hospital that has a high readmission rate will see a decrease in insurance

reimbursement. This metric allows them to understand whether the hospital is doing its best to

prevent complications and safely transition the patient to home. For example, when a hospital

has many unplanned rehospitalizations, they are less likely to have the patients return to the

hospital and choose a different one. This will also show the hospital with fewer reimbursements

from Medicare. This metric allows the hospital to plan properly regarding discharge and not to

push the patients out too early. (Hospital readmissions reduction program). The readmission rate
at Saint Francis Medical Center is 15.1%, and Methodist Medical Center is 13.9%. The national

average is 14.6%.

Summary of analysis

Value-based quality care metrics help reinforce healthcare. This allows the patient to get

the best health care available and improves the quality of services instead of the quantity.

Healthcare providers and hospitals can only be compensated based on patient outcomes. This

type of compensation is an incentive to promote healthier patients, reduce chronic disease

complications, and help patients live more active and healthy lives. The CMS says value-based

care helps improve AAA by providing better care for individuals, improving health for the

population, and decreasing the cost. (Allscripts Healthcare LLC, n.d.) Based on the outcome of

the metrics, it is essential to understand that there are negative and positive outcomes for the

healthcare stakeholders. Based on value-based care can significantly improve the patient's health

care and get better quality care focused on them rather than quantity. Better surveys will have

better reimbursement, while bad surveys will have poor reimbursement.

Value-based healthcare metrics significantly impact stakeholders, from insurance

providers to patients and hospitals. The insurance can use quality metrics to understand various

things about the hospital. The insurance providers need to understand the value of care patients

are receiving in the hospital and how that will be affected by the reimbursement the hospitals get

from the insurance companies. It allows the hospitals to see the gaps and mistakes that they're

making in the hospital. They can rectify these issues, have better outcomes, and improve

healthcare for individuals. For the patient's value, value-based quality metrics allow them to
understand their availability to evaluate the care and quality of care they receive from the

hospital. It will enable them to choose the best hospital for their needs. Comparative analysis,

however, has no way of knowing about the data of the underserved and lower socioeconomic

populations in the community these two hospitals serve. The populations often have minimal

economic resources because of high unemployment rates, and this causes them to be uninsured.

Cultural differences and language barriers also prevent many populations from accessing health

care. A lower educational level, along with poor housing and environmental challenges, can

cause someone to be hospitalized unnecessarily and tested unnecessarily because they cannot

communicate the symptoms correctly. This will also cause readmissions. (Bhatt &Bathija,2018)
 References

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