Healthgrades

Last updated
Healthgrades Marketplace, LLC
Company type Subsidiary
Industry Health care
Founded1998;26 years ago (1998)
Headquarters
Charlotte, NC
,
United States
Key people
Jeff Hallock, Chief Executive Officer, RVO Health Steve Olin, President, Health Services
Parent RVO Health
Website healthgrades.com

Healthgrades Marketplace, LLC, known as Healthgrades, is a US company that provides information about physicians, hospitals, and healthcare providers. [1] [2] [3] [4] [5] Healthgrades is part of RVO Health, [6] a partnership between Red Ventures and Optum, part of UnitedHealth Group. Healthgrades has amassed information on over three million U.S. health care providers. [7] The company was founded by Kerry Hicks, David Hicks, Peter Fatianow, John Neal, and Sarah Lochran, and is based in Denver, Colorado. [3] Jeff Hallock serves as RVO Health's CEO. [3] According to USA Today , Healthgrades is the first comprehensive physician rating and comparison database. [8] The application is part of a trend in health technology in the United States towards consumer-driven healthcare. [9]

Contents

History

Kerry Hicks founded Healthgrades in 1998. [3] Prior to founding Healthgrades, Hicks served as CEO of its predecessor company, Specialty Care Network. [3] In 2008, Healthgrades acquired Ailjor, an online healthcare directory. [10] Healthcare providers could display their business information on the website for the community to view. [11] In 2009, Healthgrades worked with over 400 hospitals in the United States. [1]

An affiliate of Vestar Capital Partners, a private equity firm, acquired Healthgrades in 2010. [12] Healthgrades merged with CPM Marketing Group, a Madison, Wisconsin based company that provides customer relationship management solutions to hospitals. [13] CPM Marketing became CPM Healthgrades, a division of Healthgrades, and now operates as Healthgrades Hospital Solutions group. [13] The merger created a single online company with more than 200 million visitors annually. [14]

In October 2014, Healthgrades launched the first comprehensive physician rating and comparison database in the United States. [8] The database allows users to search for physicians based on their experience in a particular area or procedure. [8] The database's launch coincided with the release of a company-produced report that showed widely varying complication rates for total knee replacement surgeries across 17 Denver-area hospitals. [8] On August 4, 2021, the Healthgrades.com marketplace was sold to Red Ventures while the technology and data platform division rebranded to Mercury Healthcare. [15]

In 2022, RV Health, a Red Ventures business consisting of Healthgrades, Healthline Media (Healthline, Medical News Today, Greatist, Psych Central, Bezzy), and PlateJoy, became a new company in partnership with UnitedHealth Group's Optum. The new company, RVO Health, combines RV Health's content, chronic condition communities, and tools with Optum Perks, Optum Store, and Rally Coach. [16]

Ratings

Healthgrades evaluates hospitals solely on risk-adjusted mortality and in-hospital complications. [17] Its website evaluates roughly 500 million claims from federal and private reviews and data to rate and rank doctors based on complication rates at the hospitals where they practice, experience, and patient satisfaction. [8] Its analysis is based on approximately 40 million Medicare discharges for the most recent three-year time period available. [17] Hospital rating reports for specific procedures and diagnoses are compiled primarily from Medicare claim data and include all hospitals that are Medicare participants. [18] Some critics argue that claim data is not adequate to make determinations about the quality of care and that conclusions should be drawn from medical records. [18] Peer-reviewed research has shown that measures of mortality and complication rates based on administrative data can be used to measure clinical quality. Ratings are updated yearly, but data is two years old before Medicare releases it. [1] [18] [19]

Healthgrades develops objective ratings based on data and information from several publicly available sources. [18] The data is analyzed using a proprietary methodology that identifies the recipients of the various awards and the "1-3-5 Star" designation. [20] Specifically, most ratings are determined from multivariate logistic regressions of medical outcomes at a given healthcare provider to risk-adjust the patients and 1-, 3- and 5-star awards are given to providers whose negative outcomes are worse than expected, near predicted levels, and better than expected, respectively. The ratings have been criticized for oversights in the methodology that may penalize some institutions with ideal medical outcomes. [21] Nash et al. have expressed "concern about the reliability and validity of such 'black box' rating scales." [22]

In addition to star ratings, Healthgrades recognizes facilities for America's 50,100, and 250 Best Hospitals, Specialty Excellence Awards, Outstanding Patient Experience, and Patient Safety. [23] The hospital quality awards bestowed by Healthgrades are intended to help patients make an informed choice about where to get treated. [24]

Products

Website

Time listed the Healthgrades website as one of its 50 best websites of 2011. [25] The information Healthgrades provides includes information on doctors' board certifications, types of procedures offered, and which insurance plans offices accept. [7] [26] However, information such as healthcare provider degrees is often inaccurate on the site, significantly limiting its use and raising concern that other information on the site may also be incorrect. It also lists a doctor's hospital affiliations and information on hospital performance collected from government data. Web visitors can input their opinions in a survey based on their experience with an individual healthcare professional and view provider ratings at no charge. The survey evaluates a doctor's communication skills, the friendliness of the office staff, and whether it's easy to get an urgent appointment. [26] Healthgrades was featured in a study analyzing the trends of otolaryngologists' online ratings published in JAMA in 2014. [27] The study confirmed that although physician's feelings toward the presence of online rating websites tend to be negative, the awareness of and the use of them by patients has increased and may help physicians manage their online reputation. [27]

According to comScore, Healthgrades began receiving approximately 17 million unique visitors monthly in January 2014. [28] Many companies and health plans make Healthgrades information available to their participants. [29]

Licensing

Hospitals that are highly rated providers will license Healthgrades' ratings and trademarks for marketing promotions. The company uses litigation to protect its name and ratings. Healthgrades sued the Robert Wood Johnson University Hospital in 2006 for copyright and trademark infringement after the hospital used Healthgrades' ratings and logo in promotional publications without paying licensing fees. [20]

Independent evaluation

Medical experts have questioned the reliability of the 1-, 3- and 5-star ratings given to healthcare providers, criticizing the lack of transparency and perceived oversights in Healthgrades' methodology. [21] [22]

A study published in JAMA in 2002 reported that Healthgrades ratings for mortality associated with acute myocardial infarction identified "groups of hospitals differing in the aggregate in quality of care and outcomes" but heterogeneity within the ratings for individual hospitals could not reliably discriminate between individual hospitals in quality of care or mortality. [30] To illustrate: for any pair of hospitals rated to two different rating groups (1-, 3- or 5-star) by Healthgrades, the researchers determined that standardized mortality rates were "comparable or even better in the lower-rated hospital in more than 90% of the comparisons." [30]

The Rocky Mountain News concluded that Healthgrades had inaccurate physician disciplinary records (while competitor ChoicePoint had much greater accuracy) in 2004. [31] The report also detailed the complaints of former Healthgrades employees and physicians that pursued legal actions after inaccurate reports. [31]

Research published in Journal of the American College of Surgeons in 2010 compared mortality in U.S. News & World Report and Healthgrades lists of "Best Hospitals" for abdominal aortic aneurysm repair, coronary artery bypass, aortic valve repair and mitral valve repair. [32] Risk-adjusted mortality was found to be statistically significantly lower in the Healthgrades' "Best Hospitals" for coronary artery bypass and aortic valve repair. [32]

A similar study published in Archives of Surgery in 2011 evaluated Healthgrades and U.S. News & World Report ratings in oncologic surgeries, comparing top-rated hospitals in the two reports to all other U.S. hospitals. [33] The authors determined that both ratings systems had substantive flaws in the evaluation of mortality following pancreatectomy, esophagectomy or colectomy; only the top rated hospitals for colectomy in the U.S. News & World Report ratings had a statistically significant lower mortality than national averages—mortality rates at Healthgrades' best hospitals were not significantly lower for any of the three procedures. [33]

The eHealthcare Awards gave Healthgrades a platinum award for Best Doctor Directory, Consumer General Health in 2019 and 2021, [34] and Best Provider Directory, Consumer General Health in 2023.

Criticism

In 2010, AOL criticized the company for its use of "automatic renewal" subscription charges to customers who purchased physician reports. [35] Healthgrades discontinued all consumer-based credit card product offerings in 2011. In addition, ConsumerAffairs.com shows an unfavorable rating of Healthgrades.com, listing allegations of inaccurate healthcare provider information, modified or falsified reviews left by consumers, and an inability to validate reviews properly before being posted. [36] A 2016 article published in Consumer Reports identified a case where Healthgrades failed to divulge 18 malpractice suits against Leonard Kurian, a physician reviewed on its site, bringing into question the quality of reviews it provides. [37] Healthgrades will disable and remove therapy and psychology accounts if requested.

Healthgrades Help Center FAQs [38] states providers who have received an unsatisfactory patient survey may improve their overall survey score: “The best strategy to improve your overall survey score is to encourage more of your patients to complete Patient Satisfaction Surveys. The more patient surveys you have, the less impact a few bad scores have on your overall survey score. Use our Patient Engagement Resources to help you encourage patients to complete surveys.” This suggestion to providers from Healthgrades violates both National Association of Social Workers Code of Ethics [39] and American Psychological Code of Ethics: [40] The Code of Ethics of the National Association of Social Workers, Section 4.07, states that it is unethical for social workers to solicit testimonials: "(b) Social workers should not engage in solicitation of testimonial endorsements (including solicitation of consent to use a client's prior statement as a testimonial endorsement) from current clients or other persons who, because of their particular circumstances are vulnerable to undue influence." Also, The American Psychological Association's Ethics Code states that it is unethical for psychologists to solicit testimonials: Principle 5.05 "Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable."

Related Research Articles

<span class="mw-page-title-main">Health care</span> Prevention of disease and promotion of well-being

Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. The term includes work done in providing primary care, secondary care, tertiary care, and public health.

<span class="mw-page-title-main">Physical examination</span> Process by which a medical professional investigates a patients body for signs of disease

In a physical examination, medical examination, clinical examination, or medical checkup, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patient's medical history followed by an examination based on the reported symptoms. Together, the medical history and the physical examination help to determine a diagnosis and devise the treatment plan. These data then become part of the medical record.

The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.

...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.

Computerized physician order entry (CPOE), sometimes referred to as computerized provider order entry or computerized provider order management (CPOM), is a process of electronic entry of medical practitioner instructions for the treatment of patients under his or her care.

In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. Integrated delivery systems where insurers and providers share in the cost are intended to help align incentives for value-based care.

Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of lives". This includes pharmaceuticals, devices, procedures, and organizational systems used in the healthcare industry, as well as computer-supported information systems. In the United States, these technologies involve standardized physical objects, as well as traditional and designed social means and methods to treat or care for patients.

Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.

Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.

A patient safety organization (PSO) is a group, institution, or association that improves medical care by reducing medical errors. Common functions of patient safety organizations are data collection, analysis, reporting, education, funding, and advocacy. A PSO differs from a Federally designed Patient Safety Organization (PSO), which provides health care providers in the U.S. privilege and confidentiality protections for efforts to improve patient safety and the quality of patient care delivery

Health information technology (HIT) is health technology, particularly information technology, applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors. Based on a 2008 report on a small series of studies conducted at four sites that provide ambulatory care – three U.S. medical centers and one in the Netherlands, the use of electronic health records (EHRs) was viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system.

Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. A discipline-specific process may be referenced accordingly.

<span class="mw-page-title-main">Healthcare in the United States</span>

Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance. The United States spends more on healthcare than any other country, both in absolute terms and as a percentage of GDP; however, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations. Coverage varies widely across the population, with certain groups, such as the elderly and low-income individuals, receiving more comprehensive care through government programs such as Medicaid and Medicare.

<i>Consumers Checkbook</i>

Consumers' Checkbook/Center for the Study of Services is an independent, nonprofit consumer organization. It was founded in 1974 in order to provide survey information to consumers about vendors and service providers. There are both print and online publications in the Boston, Chicago, Delaware Valley, Puget Sound, San Francisco/Oakland/San Jose, Twin Cities, and Washington, D.C., areas. Currently most of the Center's income comes from doing contract surveys for major health plans.

Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.

Atlantic Health System is one of the largest non-profit health care networks in New Jersey. It employs 18,000 people and more than 4,800 affiliated physicians. The system offers more than 400 sites of care, including six hospitals: Chilton Medical Center, Goryeb Children’s Hospital, Hackettstown Medical Center, Morristown Medical Center, Newton Medical Center and Overlook Medical Center.

<span class="mw-page-title-main">Health information on the Internet</span>

Health information on the Internet refers to all health-related information communicated through or available on the Internet.

Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider.

Doctors Hospital of Laredo is a for-profit hospital owned and operated by Universal Health Services. There are 164 physicians on the medical staff with the hospital, 80 of whom are active staff. Has a Level III Trauma Center and a Level III NICU, as well as a wide array of medical services. Doctors Hospital of Laredo is located at 10700 McPherson Rd. in Laredo, Texas, United States.

Health care efficiency is a comparison of delivery system outputs, such as physician visits, relative value units, or health outcomes, with inputs like cost, time, or material. Efficiency can be reported then as a ratio of outputs to inputs or a comparison to optimal productivity using stochastic frontier analysis or data envelopment analysis. An alternative approach is to look at latency times and delay times between a care order and completion of work, and stated accomplishment in relation to estimated effort.

Optum, Inc. is an American healthcare company that provides technology services, pharmacy care services and various direct healthcare services.

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