We knew it was a big deal for hospitals across the country: Starting this month, Medicare administrators are rewarding or penalizing them financially based on the quality of their care.
It’s an important part of the larger picture of how the Affordable Care Act, with special significance for New York City. Studies suggested that safety-net hospitals — those that care for particularly sick, poor or uninsured patients — would fare badly under the new rules. Most local hospitals fit that description, so it made sense to look at the rules and their impacts, and then tell the story of how New York City would be affected.
Making the data accessible and easy to understand would be a central part of that story. In August, the federal Centers for Medicare and Medicaid Services (CMS) published preliminary data, which showed that New York City would not do well, either in comparison to national averages or to other large cities. But to really demonstrate that finding, we had to present an easily readable and searchable data table that showed the penalties and causes.
CMS published the rates as “factors,” or reductions to repayments from 100 percent. So we had hospitals that were getting .99238 of their total, which isn’t really a natural way to understand how much a hospital would lose.
So we decided for simplicity’s sake to turn those factors into “penalties,” showing how much out of the maximum 2 percent a hospital would lose or gain under the rules.
After some quick math in Excel, merging the spreadsheets by a unique identifier was next. This isn’t a difficult task if you’re familiar with Microsoft Access, MySQL or Google Refine: each hospital has a unique number given by CMS which we used to merge data from multiple spreadsheets, each showing how hospitals performed on a different part of their evaluation.
From there we took averages of New York City hospitals, large cities like Los Angeles and Chicago, and the rest of the nation to provide context. New York City proved to be one of the most heavily penalized large cities. On average, facilities in the Bronx, Brooklyn and Queens got hit with penalties four times greater than the average hospital nationally.
Ultimately, these numbers are only preliminary. But because they are based on three years of data compiled by CMS, they are likely to mirror the penalties that will be sent to hospitals later this month. And for once, it will be hospitals’ turn to be shocked at their bills.
To browse more detailed information, head over to CMS’s Hospital Compare website. There you can find performance statistics on an array of hospital procedures and outcomes — mortality rates for heart attack patients, rates of blood infections and even how often surgeons accidentally leave objects in a person’s body after surgery. With this information, you can make your own diagnosis on your hospital’s performance.