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Hospital quality scores allow regulatory agencies like the Centers for Medicare and Medicaid Services (CMS) to understand how effectively providers are treating patients and reimburse the hospitals appropriately. Some of the most informative quality performance metrics include HCAHPS patient survey scores, 30-day readmissions, rates of hospital-acquired conditions (like MRSA and SSIs), and more. In this article series, we are highlighting the hospitals with the poorest quality score performance by state based on Definitive Healthcare's data.
Texas has the greatest number and highest percentage of uninsured residents in the U.S. according to an Urban Institute analysis. More than 4.7 million Texans, or 19 percent of the state population, do not have health insurance coverage. This is particularly alarming when coupled with high rates of obesity (33 percent) and maternal mortality (34.2 per 100,000 live births). Analyzing the quality scores of Texas can help CMS and care providers identify where improvement is most needed. We’ve compiled the 30 Texas hospitals with the worst performance across three quality measures.
|Rank||Definitive ID||Hospital Name||Readmission Rate||Net Patient Revenue||Discharges|
|1.||3994||Memorial Hermann Northeast Hospital||17.4%||$246,447,308||13,914|
|2.||3900||Medical City McKinney||17.1%||$191,707,195||9,924|
|3.||552496||Baylor Scott & White Orthopedic and Spine Hospital - Arlington||17.0%||$102,306,477||1,679|
|4.||3911||Baylor Scott & White Medical Center - Lake Pointe||16.7%||$175,700,213||7,966|
|5.||3943||Medical City Lewisville||16.7%||$134,857,558||6,456|
|6.||4029||CHRISTUS Good Shepherd Medical Center - Marshall||16.7%||$88,188,917||3,616|
|7.||4052||CHRISTUS Southeast Texas Jasper Memorial||16.6%||$25,492,176||1,086|
|8.||3917||Medical City Las Colinas||16.6%||$94,864,124||5,329|
|9.||3979||Texoma Medical Center||16.6%||$334,235,976||16,634|
|10.||3975||John Sealy Hospital||16.5%||$588,048,288||32,396|
Fig 1 Data from Definitive Healthcare’s comprehensive platform, including intelligence on over 8,800 hospitals and IDNs in the U.S. Quality metrics from reporting period ending June 30, 2017, the most recent available.
All-cause readmission rate refers to patient readmissions to care facilities within 30 days of acute care treatment and initial discharge. Reducing preventable readmissions, particularly for hospital-acquired conditions, indicates that providers are proactive and comprehensive in addressing patient health needs and are appropriately staffed in relation to patient volume. High rates of 30-day readmissions spotlight areas where hospitals can improve quality performance through patient education, improved device sanitation, medication management, and other methods.
In the table above, we’ve compiled the 10 Texas hospitals reporting the highest 30-day readmission rates. There doesn’t appear to be a strong correlation between either net patient revenue or discharges and high readmission rates. CHRISTUS Southeast Texas Jasper Memorial reported the lowest net patient revenue and fewest discharges of the hospitals listed, ranking 7th of all Texas hospitals. John Sealy Hospital, which reported the highest net patient revenue and most discharges of those listed, ranked 10th. This appears counterintuitive, as a hospital with higher revenues would likely have greater funds to devote to improved care delivery methods.
|Rank||Definitive ID||Hospital Name||Mortality Rate||Net Patient Revenue||Discharges|
|1.||4196||Wise Health System - East Campus||17.1%||$274,265,531||5,003|
|2.||4181||Laredo Medical Center||16.5%||$214,066,005||13,484|
|3.||4080||University Medical Center||16.4%||$498,309,770||21,018|
|4.||3860||Baptist Medical Center||16.2%||$1,034,929,360||61,141|
|5.||3899||Texas Health Presbyterian Hospital Plano||16.2%||$401,219,214||19,905|
|6.||3942||Baylor Scott & White Medical Center - Carrollton||16.1%||$105,867,952||5,028|
|7.||3866||Wadley Regional Medical Center||16.0%||$109,012,495||6,444|
|8.||3871||CHI St Joseph Regional Health Care Center||16.0%||$308,326,703||13,146|
|9.||4128||UT Health Tyler||16.0%||$358,386,829||20,693|
|10.||4097||Nacogdoches Memorial Hospital||15.6%||$54,793,295||3,604|
Fig 2 Data from Definitive Healthcare’s comprehensive platform, including intelligence on over 8,800 hospitals and IDNs in the U.S. Quality metrics from reporting period ending June 30, 2017, the most recent available.
CMS tracks hospital mortality rates specifically for COPD, heart attack, heart failure, pneumonia, and stroke for quality-based reimbursements. According to a study from JAMA, hospital performance on mortality from pneumonia, heart attack, and heart failure are linked to the facility’s overall mortality rates. The study found that the top 25 percent of hospitals with the lowest mortality rates in these areas reported an overall mortality rate 3.6 percent lower than hospitals in the bottom quartile.
Baptist Medical Center, ranked 4th by heart attack mortality rate, reported the highest net patient revenue and the most discharges by far. In stark contrast, Nacogdoches Memorial Hospital ranked last on the list with the lowest net patient revenue and fewest discharges. None of the hospitals reporting the highest heart attack mortality rates appear on the list of highest all-cause readmission rates.
|Rank||Definitive ID||Hospital Name||Score||Total Revenues||Discharges|
|1.||3866||Wadley Regional Medical Center||3.36||$111,005,852||6,444|
|2.||4177||Citizens Medical Center||2.86||$153,570,421||6,270|
|3.||4108||Medical City Weatherford||2.81||$90,842,383||5,286|
|4.||4178||Huntsville Memorial Hospital||2.62||$87,616,807||4,567|
|5.||3857||Southwest General Hospital||2.55||$108,277,824||9,637|
|7.||4176||DeTar Hospital Navarro||2.23||$205,423,142||8,483|
|8.||3979||T exoma Medical Center||2.16||$338,282,273||16,634|
|9.||4068||Paris Regional Medical Center||2.02||$133,301,107||6,549|
|10.||4094||Conroe Regional Medical Center||1.91||$227,953,744||15,359|
Fig 3 Data from Definitive Healthcare’s comprehensive platform, including intelligence on over 8,800 hospitals and IDNs in the U.S. Quality metrics from reporting period ending December 31, 2017, the most recent available. CMS scores hospitals based on MRSA prevalence on a scale of 0 to 3, with 0 being the best possible score.
The Methicillin-resistant Staphylococcus aureus (MRSA) bacteria is resistant to many commonly used antibiotics and causes serious conditions like infections of the bloodstream and surgical sites, pneumonia, and even death if left untreated. MRSA is spread through direct contact, which further incentivizes care providers to maintain high sanitation standards when treating multiple patients in succession.
Wadley Regional Medical Center, with the worst MRSA infection score on the list, reported the 4th lowest total revenues and discharges of the hospitals listed. None of the hospitals with the highest MRSA infection scores reported more than $350 million in total revenues, which could suggest that lower-revenue hospitals may not be performing as well as higher-revenue hospitals due to lack of resources. This was also true of the California hospitals with the lowest quality scores.
Why are quality scores important to suppliers? Learn more about how to leverage quality data when targeting care facilities in our webinar: Selling to Hospitals in the 2019 Landscape.
This webinar covers how to:
BLOG: 30 Worst California Hospitals by Quality Score Performance
BLOG: 25 Hospitals with the Best and Worst HCAHPS Scores
BLOG: 10 States with the Most Hospital-Acquired Infections
INFOGRAPHIC: Top 5 Chronic Health Conditions Impacting Population Health