BlueCompare for Hospitals Frequently Asked Questions
The Accreditation category has been revised to include accreditation offered by the American Osteopathic Association and DNV Healthcare Inc. Hospital Readmission Rates, calculated using Blue Cross and Blue Shield of Texas (BCBSTX) claims data, were added as an informational only measure on the BlueQ Report.
The BlueQ Performance Ribbon is based on the BlueQ Hospital Scorecard that reports the hospital's performance on The Joint Commission©, DNV Healthcare Inc. or American Osteopathic Association, Leapfrog, and the Centers for Medicare and Medicaid Services (CMS) related to patient safety and process of care indicators. The report includes measures such as appropriate ICU staffing, management of patients with cardiac conditions such as heart attack and heart failure and patient safety measures. Also recognized is the hospital's participation in voluntary initiatives for American Nurses Credentialing Centers' (ANCC) Magnet Recognition Program® or Pathway to Excellence™ designation. Consideration is also given to Blue Distinction® Centers that are recognized for excellence in bariatric surgery, cardiac care, complex & rare cancers, knee and hip replacement, spine surgery, and transplants. The overall results are compiled using publicly reported sources as well as BCBSTX inpatient surgical admissions and hospital readmission rate data.
The BlueCompare Affordability Scale compares general acute care hospitals on medical/surgical costs for inpatient admissions and outpatient services. The average cost of inpatient stays and outpatient services is adjusted so hospitals performing more complex procedures on sicker patients can be reasonably compared to hospitals performing less complex procedures on less sick patients. The costs analyzed include all services provided by the hospital during an inpatient stay, such as labs, X-rays, and medications, as well as the room and board charges, and all services provided in the outpatient setting.
A dark blue ribbon indicates the medical/surgical general acute care hospital is recognized for exceeding expected performance compared to other hospitals in the same geographic region. A light blue ribbon indicates the medical/surgical general acute care hospital is recognized for meeting expected performance compared to other hospitals in the same geographic region. A clear ribbon indicates the medical/surgical general acute care hospital did not meet expected performance compared to other hospitals in the same geographic region.
A hospital may not have a ribbon if:
- The hospital did not have sufficient data at the time of measurement.
- The hospital is not a general acute care facility.
The results used for the BlueQ Ribbon come from several publicly reported sources:
- The Leapfrog Group
- The Joint Commission
- DNV Healthcare Inc.
- American Osteopathic Association
- The Center for Medicare and Medicaid Services (CMS)
- American Nurses Credentialing Center (ANCC) Magnet Recognition Program or Pathway to Excellence
- Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
- Blue Distinction Centers Program
Medical/Surgical general acute care hospitals are evaluated on an annual basis, with BlueQ reports and Affordability Scale information communicated annually in the Fall and BlueCompare results posted via the internet around the beginning of the following year.
In order to be evaluated for an Affordability Scale, a medical/surgical general acute care hospital must have data available to measure affordability for an inpatient and/or outpatient admission. An Affordability symbol is not displayed for general acute care hospitals that are new to the network.
All medical/surgical general acute care hospitals were evaluated for reporting, however, some facilities did not receive a report as there was no data available from any of the reporting sources for certain hospitals.
Hospitals or facilities that are not classified as a medical/surgical general acute care hospital on BCBSTX Provider Finder did not receive a report. Examples include pediatric hospitals, rehabilitation facilities, and psychiatric hospitals.
According to Leapfrog's Web site and the Hospital Quality and Safety Survey FAQs, hospitals that should report to Leapfrog include acute care and short term general acute care hospitals. Leapfrog does not specify the number of beds a hospital must have to report survey results.
According to the Leapfrog Web site, hospitals should have submitted a 2012 survey by June 30, 2012 to be included in Leapfrog's first release of 2012 survey results. Those results were released in late July and fully replaced all 2012 survey results. If a facility failed to complete and submit a survey, a survey may still be submitted. At the end of August and monthly thereafter, Leapfrog will update and release results on the second business day of the following month based on 2012 surveys (re)submitted by the end of the month.
BCBSTX sourced results for the 2012 BlueQ report from Leapfrog's website as of August 2012.
Results were sourced from Leapfrog's Web site and the following values assigned by BCBSTX:
Fully Meets Standard, 2 points
Substantial Progress, 1 point
Some Progress, 1 point
Willing to Report, 1 point
Null, 0 points
Did Not Report, 0 points
Not Applicable, 0 points
Not Targeted, 0 points
Possible points and points earned were summed for the category and are a part of the overall hospital score.
Results were sourced from The Joint Commission website and the following values were assigned by BCBSTX:
Accredited, 5 points
Provisional Accreditation, 4 points
Conditional Accreditation, 3 points
Denial of Accreditation, 0 points
Not Accredited, 0 points
Or 5 points for either Accreditation by DNV Healthcare Inc, or American Osteopathic Association
Results were sourced from American Nurses Credentialing Center’s Web site and the following values assigned by BCBSTX:
- Pathway to Excellence designation, 3 points
- Magnet Recognition Program, 3 points
Points were awarded for one program or the other.
Points were awarded for each Blue Distinction designation, 2 points for each designation, for a maximum of 10 points, and applied to the numerator only.
Can a medical/surgical general acute care hospital opt out of the BlueQ Ribbon display in Provider Finder?
Yes, a medical/surgical general acute care hospital can choose to opt out of the BlueQ Ribbon display in Provider Finder. The opt out form, included in the Blue Compare packet, must be completed and submitted.
If a hospital's rate on a measure in the BlueQ scorecard is higher than the state and/or the national rate, why did the hospital not earn the maximum number of points?
The national, state, and hospital rates shown on the BlueQ scorecard are averages provided by CMS and HCAHPS. The number of points a hospital earns for a measure is based on the percentile in which the hospital rate falls. So in some cases, a hospital's rate for a particular measure can be higher than the state or national average, but still not be in the percentile to qualify for the maximum number of points.