An article in the New York times discussess the new HHS reporting on mortality for cardiovascular admissions, (among other things). It was clear that the executive branch was not too enthusiastic in the first place. Not clear why they relented, but the link to the HHS site containing the "report" takes you to a fragmented database query screen that after some significant massaging gave me the reassuring news that none of the Nevada Hospitals were any worse (or better) than the other 4400+ average hospitals in the country. No "shame" list of the worst, no "praise" list of the best. You gotta ask the right question. Fifteen years ago, when I was Chief of Staff, every hospital in town had much better data on outcomes than has ever seen the light of day. It is in everyone's commercial interest to advertise the "perception of quality" rather than compete on outcomes and measurable quality. Data has a pesky way of getting in the way; just ask GM.
There was another thing in the paper a while back; Geisinger clinic in PA is marketing surgery with a warranty; 90 days fixed price, all costs included CV surgery. Bring-backs - 0$. Sternal debridements - 0$ Pacers/AICDs - 0$(?) Don't know that one. Presuming they hike their doctor reimbursement appropriately, that's a nice way to align everyone around efficient, good outcomes. Mike and Rob, what do you think?