Measure for Measure: Florida Opens a Window On Health Competence

A new state-backed service, Florida Compare Care, is bringing consumers and health care providers a new way to assess health care. The health statistics Web site, which went live this past November, lists prices for pharmaceutical and surgical procedures at Florida's hospitals and rates outcomes of common procedures performed there. The site, the first of its kind in the nation, will also include physician and health plan information.

For all the advances it makes in providing useful information, the site--www.floridacomparecare.gov--is not without controversy.

Hospitals are concerned that the ratings on procedural outcomes may not be used properly. Specific outcomes at each hospital are given one of three rankings, "higher than expected," "as expected" or "lower than expected," rather than being compared to a "risk adjusted" rate. Since many different factors affect the rankings, the outcomes are not meant for side-by-side comparison--a fact health care providers fear the public may disregard or may not understand.

According to Rich Rasmussen, a vice president with the Florida Hospital Association, one of the variables is the method for collecting information. Billing codes are used to compile outcome data, so those hospitals with more specific codes may appear worse because they report more completely. A disclaimer on the site alerts users to this and also explains that death or complications may occur with any procedure regardless of how well the standards of care are followed.

With 90,000 people per year dying from infections acquired in hospitals and research showing that the death rate at a hospital may be directly related to the quality of care received, the state hopes that the site, despite its comparison flaw, will make Florida's 228 outpatient and acute-care hospitals more aggressive in improving patient outcomes.