Abstract 288: Payments, Mortality and Readmission Rates in US News and World Report “Best Hospitals” in Cardiology

Abstract

Background: Little is known regarding how well the U.S. News & World Report “Top-Ranked Hospitals for Cardiology and Heart Surgery” rankings reflect performance on key measures such as thirty-day risk-standardized mortality, readmissions, and payment. Methods: We used publicly available US News and World Report rankings of the top 50 best hospitals from 2014 to 2017 to stratify hospitals into ranked and unranked hospitals and utilized data from Medicare’s Hospital Compare database. Risk-standardized measures for payments, mortality rates, and readmission rates for Acute Myocardial Infarction (AMI) and Heart Failure (HF) in ranked and unranked hospitals were compared using two-tailed t-tests. Results: There were n=66 ranked hospitals and n=1846 unranked hospitals included in the analysis. As compared with unranked hospitals, top ranked hospitals had significantly lower thirty-day mortality rates for both AMI and HF (p<.001 for both; Table 1). There were no differences in thirty-day readmission rates. Thirty-day payments were significantly higher for top ranked hospitals for AMI (2014 and 2015) and HF (2015) over the study period. Conclusion: We found that US News and World Report “Best Hospitals” performed significantly better on mortality measures but not on readmission measures. While payment in ranked hospitals may have been significantly higher in 2014 and 2015, greater increases in payments of unranked hospitals closed the gap between payments in ranked and unranked hospitals. As cost-efficiency is an important component of hospital performance, future research should explore how “Best Hospitals” are keeping costs down, and future ranking algorithms should incentivize decreased payments.