2019 Study Finds Top-Performing US. Health Systems Provide Better Care at Lower Cost Than Peers Evaluated in the Study
IBM Watson Health published its 15 Top Health Systems™ annual study identifying top-performing health systems in the US. based on overall organizational performance. This study spotlights the best–performing hospitals in the U.S. using a balanced scorecard that reviews publicly available data for clinical, operational and patient satisfaction metrics. Conducted annually since 2008, the 15 Top Health Systems study is part of the Watson Health 100 Top Hospitals® program, which leverages advanced data, science and analytics capabilities to calculate hospital and health system performance benchmarks.
The 15 Top Health Systems study found that the top-performing health systems in the country achieved better risk-adjusted outcomes and higher patient satisfaction scores while simultaneously maintaining a lower average cost per patient than other health systems evaluated in the study.
“The multi-year trend toward increased healthcare consolidation2 has shined a spotlight on health system performance, illuminating both the challenges of coordinating care across multiple facilities and the opportunities that can come with scale,” said Ekta Punwani, 100 Top Hospitals® program leader at IBM Watson Health. “The institutions recognized in the IBM Watson Health 15 Top Health Systems study are providing a blueprint for how to improve quality, lower costs and achieve outstanding patient satisfaction on a consistent basis.”
Kyu Rhee, M.D., M.P.P., vice president and chief health officer at IBM Watson Health, added: “The growing trend of hospital consolidation into larger, more complex health systems has yielded benefits3, but it also has presented challenges to hospital administrators who must now integrate disparate data sets, acquire actionable insights and assure the health of larger communities. These winning health systems are demonstrating the power of aligning best practices, including utilizing data, across multiple hospitals to achieve greater efficiency while delivering a higher overall quality of care.”
The following are the key performance measurements on which 15 Top Health Systems showed the most significant average outperformance versus peer group health systems (full study results available here). Top health systems demonstrated:
- Fewer Deaths: Overall, 13.8 percent fewer in-hospital deaths.
- Fewer Complications and Infections: Patients experienced 12.6 percent fewer complications and 9.8 percent fewer healthcare-associated infections.
- Shorter Length of Stay: A median severity-adjusted length of stay that was one half-day shorter (0.5) than peers.
- Shorter Emergency Department Wait Times: Overall, median emergency department wait times that were 38 minutes shorter per patient.
- Lower Spend: Combined in-hospital and post-discharge costs were 1.1 percent lower per episode.
- Higher Patient Satisfaction: Overall hospital experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), was rated 2.5 percent higher for leading health systems.
The Watson Health 15 Top Health Systems study evaluates health system performance across nine clinical and operational performance benchmarks: risk-adjusted inpatient mortality index, risk-adjusted complications index, mean healthcare-associated infection index, mean 30-day risk-adjusted mortality rate, mean 30-day risk-adjusted readmission rate, severity-adjusted length of stay, mean emergency department throughput, Medicare spend per beneficiary index and HCAHPS score. This year, IBM Watson Health also began testing a series of new measures that update the basic standards of inpatient care, including outpatient imaging efficiency for breast and chest scans, process of care for severe sepsis and septic shock, 30-day all-cause, hospital-wide readmissions, 30- and 90-day episode of care payment measures, excess days in acute care measures and 90-day complication measures.
Extrapolating the results of this year’s study, if all Medicare inpatients were similarly situated and received the same level of care as those treated in the Watson Health 15 Top Health Systems facilities:
- More than 60,000 additional lives could be saved;
- More than 26,000 additional patients could be complication-free;
- Healthcare-associated infections would be reduced by 10%; and
- Patients would spend 38 minutes less in hospital emergency rooms per visit.
To conduct the 15 Top Health Systems study, IBM Watson Health researchers evaluated 337 health systems and 2,961 health system member hospitals. All research was based on the following public data sets: Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR) data, and Healthcare Associated Infections (HAIs) and patient satisfaction data from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website. Hospitals do not apply to participate in the study, and winning hospitals and systems do not pay to market this honor.