Report names 17 Florida hospitals to annual list of 'top 100' in U.S.

By Michele Dula Baum
CNN.com Health and Food Writer

(CNN) -- According to a new health care survey, Florida hospitals have it where it counts.

Seventeen Florida hospitals are listed in HCIA-Sachs Institute's list of the nation's "100 Top Hospitals" -- the most of any state. Ohio came in second with 11, and Pennsylvania was third with seven. Twenty-five other states had at least one hospital on the list.

The Baltimore, Maryland-based health care management and consulting firm has been compiling a report of top-performing hospitals yearly since 1993. The study uses measures of clinical, financial and operational performance to rate hospitals. The report is based on Medicare data from 1999.

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"This year's study reflects the financial distress hospitals have encountered in the wake of the Balanced Budget Act of 1997," executive director Jean Chenoweth said. "Despite the difficulties facing them, the 100 top benchmark hospitals have maintained profitability and top clinical performance."

The "100 Top Hospitals" list includes hospitals of varying sizes and ownership. Some have fewer than 100 beds, while others are large public teaching facilities. Hospitals on the list are not ranked according to individual performance.

"What we are trying to achieve is to identify those hospitals that perform well under adverse conditions, such as managed care, as opposed to those that perform well under the old system of cost-plus, or Medicare," Chenoweth added. "We look at the quality of care for patients, and their efficiency in adapting to the health care environment."

Click here to see how many hospitals were recognized in your state

The HCIA-Sachs Institute study is one of several health care quality assessment tools available, including an annual report by U.S. News and World Report, and Health Grades Inc., a Colorado-based online service offering "report cards" on hospitals, physicians, health plans and other facilities across the country.

"All these benchmarking studies are useful, but none of them are definitive," said Chris Burch, executive vice president of the National Association of Public Hospitals. "It's always nice if you make the list, and having outside groups looking at what you're doing is good. But this is just one part of the many things you need to know" to make an informed hospital choice.

Charles Inlander, president of the People's Medical Society, a consumer advocacy group headquartered in Allentown, Pennsylvania, called the HCIA-Sachs study "a waste of time" for consumers.

"You wouldn't know, as a patient, what that hospital can do for you," Inlander said. "This is sort of like saying 'Cadillacs are good.' But that doesn't mean it's the right car for you."

The problem is that health care rating services aren't using "a standard standard," continued Inlander. "This study is a way for people to get names of hospitals. Then you need to check them out yourself -- how many procedures do they do, how long your doctor's been affiliated, with them, that sort of thing."

Yale University associate professor Harlan Krumholz has been working toward a common standard for at least eight years.

"I was just at a meeting yesterday with HCFA (Health Care Financing Administration)," said Krumholz, who is a cardiologist. "We're taking a close look at these public report cards."

The HCIA-Sachs report is based more on financial data than clinical outcomes, the cardiologist said. The list, for example, rewards shorter hospital stays and decreased costs.

"But it's not clear these are the best," he said. "At the end of the day, we're just not sure what they can provide as a public service."

To be fair, Chenoweth said the list is compiled "primarily for hospitals" and not for the benefit of consumers. "We have always published it in an industry journal that's not even sold in newsstands," she said.

But "the public has caught on" and many hospitals use their ranking in marketing campaigns, Chenoweth said.

Still, the list does provide important information that consumers can use, she added.

"What we were able to identify over five years is that hospitals that won more than once had a pure focus on continuous quality improvement," Chenoweth said. "What the consumer can depend on with this list is that these hospitals are consistently good performers."

That does not mean that a listed hospital is necessarily the best place to have your heart surgery or any other specific procedure, she agreed. "But you can depend on that facility to provide good care."

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100 Top Hospitals: Benchmarks for Success
National Association of Public Hospitals
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