California's Hospital Report Card

In March 2007, the first public report card of California hospitals was launched, enabling consumers, health care providers, and purchasers to compare hospitals in terms of quality of care, safety measures, and patient satisfaction. The www.CalHospitalCompare.org site rates hospitals in seven categories: heart attack, heart bypass surgery, heart failure, maternity care, pneumonia, other conditions, and other surgery. The ratings are based on more than 50 process and outcome measures, drawn from Joint Commission and National Quality Forum indicators. While much of the information was publicly available from various sources in the past, the new Web site brings the information together and presents it in an accessible, interactive format.



The Web site grew out of a partnership among the California Healthcare Foundation (CHCF), the University of California–San Francisco, and a newly created California Hospital Assessment and Reporting Taskforce (CHART) that represents a broad group of stakeholders, including state government. The state's Office of Statewide Health Planning is active in the steering committee, and is providing mortality data to the effort. The initiative is funded by CHCF, health plans, and hospitals. Currently, more than 200 hospitals, fewer than half of all hospitals in the state but representing over 70 percent of patient admissions, are participating in this voluntary initiative.

Early results indicate that, on average, California hospitals perform better than national averages on nearly every Joint Commission core measure. In addition, participating California hospitals perform better on measures for cardiac care than for pneumonia.

To publicize the site, the partnership will partner with consumer groups and intermediaries such as medical groups, discharge planners, and others who work directly with consumers. CHCF's Maribeth Shannon acknowledges that getting consumers to take an interest in publicly reported health data is a challenge, but that the "credible threat" of consumer engagement gets hospitals to pay attention: "The real success story is if hospitals improve their scores."

In addition to providing a decision-making tool to consumers, purchasers, providers, and health plans, the initiative is intended to help standardize data collection. The major health plans have agreed to use the report card measures for quality reporting. Los Angeles County has instituted a "pay-for-reporting" program, giving financial incentives to hospitals that participate in the initiative. Also, some health plans, including the largest in the state, WellPoint, will use the report card information as the basis for pay-for-performance programs. Updates and new measures will be added to the site over time. For example, measures for pediatric and intensive care and a Spanish-language version are planned for later this year.