BlueCompare for Hospitals Frequently Asked Questions
Additions to the 2014 BlueQ Scorecard Include:
- Leap Frog Reporting Section — Added points for Rate of Early Elective Deliveries
- CMS Process Indicators — Added
- Heart Attack — Patients Given Fibrinolytic Medication Within 30 minutes of Arrival
- Heart Attack — Patients Given Prescription for a Statin at Discharge
- Surgical Care Improvement Project — Surgery Patients Whose Urinary Catheters Were Removed on the First or Second Day After Surgery
- Surgical Care Improvement Project — Doctors Ordered Treatments to Prevent Blood Clots After Certain Types of Surgery
- Added Bonus points to Section VI — Voluntary Participation: The Joint Commission — Additional Certifications for Disease Management Programs to recognize hospitals that have earned disease specific certifications.
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 Blue Cross and Blue Shield of Texas (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 website 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 website, hospitals should have submitted a 2013 survey by June 30, 2013 to be included in Leapfrog's first release of 2013 survey results. Those results were released in late July and fully replaced all 2013 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 2013 surveys (re)submitted by the end of the month.
BCBSTX sourced results for the 2013 BlueQ report from Leapfrog's website as of August 2013.
Results were sourced from Leapfrog's website 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
- Declined to Report, 0 points
- Unable to Calculate, 0 points
- Does Not Apply, 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. DNV Healthcare Inc. or the American Osteopathic Association's 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
Results were sourced from American Nurses Credentialing Center's website and the following values assigned by BCBSTX:
- Pathway to Excellence designation, 3 points or
- 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.
Additional Bonus Points added to Section VI Voluntary Participation: The Joint Commission — up to 2 points were added for Certifications for Disease Management Programs for hospitals that have earned disease specific certifications. These points were applied to the numerator only, and were not included in the Total Possible Points.
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 distirbution, must be completed and submitted. Opting Out is available for the BlueQ Ribbon only, not the affordability Scale.
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. 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.