Improving the Accuracy of Hospital Ratings with a Focus on Volume and Outcome - Essay Example

"Improving the Accuracy of Hospital Ratings with a Focus on Volume and Outcome" is a great example of a paper on the health system.

The Centers for Medicare and Medicaid Services (CMS) has been using the method of hierarchical modeling to rank medical institutions and provide ratings based on the number of patients it serves and whether the outcome of their services is satisfactory. This method has been criticized because there has been an argument that it does not provide an accurate picture of the position of the institutions in terms of the quality of the services it provides and the number of patients it serves. The argument is that handling fewer patients does not mean that the hospital is generally below other bigger hospitals. A member of the panel recommended that they use shrinkage targets where the amount of shrinkage is divided by the original size and multiplied by 100 to find a percentage.

The CMS uses the hierarchical method because the use of well-known observed to an expected ratio based on standard logistic regression may lead to fluctuations in hospital ratings. The hierarchical method minimizes year-to-year fluctuations for small and medium hospitals. A study by Laurent G et al., (2020) found that there were few differences because of moderate to substantial agreements between the use shrinkage method and the traditional hierarchical method used by CMS. The use study found that the standard risk adjustment methodology by CMS does not interfere with the star ratings of hospitals so long as the volume of cases handled is more than the current cases of twenty-five that are used by CMS for reporting to the public.

The use of the hierarchical method by CMS is justified in the sense that a medical institution can not have high ratings if the number of people it serves is lower than other medical providers. If an institution is able to handle many patients, then it has to have a higher rating because of its capacity. In case a medical institution can handle many patients and have a more positive outcome, then it deserves to be ahead of small and medium medical institutions which serve fewer patients. The use of the hierarchical method seems fair to large hospitals because their abilities and capacities are considered. For example, if a medical institution can serve many patients and produce quality work then it becomes fair to rate it higher to increase the number of patients that visit it.

The method challenges the small institutions to improve and expand their operational capacities to have more clients and produce quality work then their star ratings will improve. Institutions can also do their own assessment to determine the position it is in comparison with other medical institutions (Nash et al., n.d). Individual assessment is necessary for helping institutions know the areas that require improvement before the overall assessment and ratings done by CMS. Small and medium organizations can adopt the current technologies in service delivery to ensure they provide quality healthcare. Technology has been proven to aid in providing healthcare services to patients' recovery and positive outcomes are always the results. Small medical institutions must also strive to expand their services to incorporate more patients into their services. This will in turn increase their ratings if the CMS still uses the hierarchical method of outcome and the number of patients to determine the medical institution's star rating.