Physician and Dentist Information
Nursing Homes Information
No. There are many thousands of procedures or conditions, and we cannot offer information on all of them. However, we have selected certain conditions and procedures that are more common or are associated with higher volumes. This way we can offer the maximum amount of information for most people.
UCHC includes data from literally hundreds of sources. We strive to obtain data from highly reliable sources that include federal and state governments, private organizations, and multiple third-party sources. Our proprietary technology and architecture result in very reliable data transformation for inclusion in our data warehouse. Our data collection and transformation processes are based on the logical, documented integration of data with multiple quality checks. This process is designed to remove mistakes and correct for missing data, provide documented measures of confidence in data, reconcile data from multiple sources, and structure data to be usable by end-user applications. Each area of our site has a full explanation of the methodology used to generate that specific report.
UCHC Comparison Reports are available for physicians, dentists, hospitals, nursing homes, mammography and fertility centers depending on which area you select. Physician reports cover training, education, specialty, certification, location of practice, and other matters of interest. Dentist information contains location of practice, education, certification and other matters of interest. Hospital reports provide mortality rates for specific conditions, readmission rates, patient satisfaction survey information, process of care measures, cost and volume information for common conditions and procedures. We also provide facility and staffing information as well as location and contact information for each hospital. Nursing home reports include information on services offered, number of beds, number of nurses, quality measures, inspection results, etc. See the "Sample Report" in each area to get a better feel for the information included. Mammography Center reports provide demographic information and any information relating to FDA Warning Letters. Fertility Center reports provide demographic, procedures offered and success rates if that information is available.
Risk adjustment is necessary to make meaningful comparisons between providers. Risk adjustment is a statistical process used to identify and adjust for variations in patient outcomes that stem from differences in patient characteristics (or risk factors) among healthcare organizations. It is a process of accounting for differences in patient populations based on potential risk factors such as age, severity of illness, risk of mortality, and other attributes.
The process of risk adjustment takes into consideration that diseases and medical conditions are rarely randomly spread across people and populations. To increase the validity of the measures, risk adjustments evaluates many factors.
You must re-enter your selection and you will be able to obtain all information previously displayed.
Physician and Dentist Information
No, UCHC does not rate physicians or dentists. Instead, we provide relevant information that allows you to assess various qualifications and specialties. This is displayed in a comparative format in your Comparison Report. Where relevant, we also include information on location, gender, medical school, post-graduate training and disciplinary actions.
UCHC compiles the physician and dentist information from over 150 independent sources. These sources include federal and state governments as well as multiple third-party sources.
UCHC makes every effort to ensure the accuracy of our data. However, due to the nature of our collection procedures and the fact that the data is self reported by physicians and dentists it is possible for it to be outdated or incorrect. We encourage users, physicians and dentists to notify us by email of any errors or updates you have found. Our email address is email@example.com.
Remember, further investigation can always prove helpful and our service is not intended to be a substitute for a patient-physician relationship. When in doubt, ask your doctor.
UCHC obtains this data from both the Office of Inspector General (OIG) and the state medical board in which the physician or dentist practices in.
The Office of Inspector General (OIG) lists individuals who have been barred from participating in federally funded healthcare programs. This is known as exclusion.
There are several reasons for exclusion, including:
- Conviction relating to fraud
- Misdemeanor conviction relating to controlled substances
- License revocation by the State Medical Board
- Surrender of a medical license while formal disciplinary actions are proceeding
- Any exclusion from any federal or state health programs
- Claims for excessive charges, fraud, or kickbacks
- Failure to report required information to various state and or government agencies
- Failure to grant immediate access for various inspections
- Failure to take corrective action on issues found during inspections
- Default of health education loans or scholarship obligations
State Medical Board public action data is provided, if it is available, for the state in which the physician or dentist practices. UCompareHealthCare makes every effort to ensure that this data is up to date in accordance with what is reported by the state medical board. The scope of this data varies by state, but generally it covers actions inclusive of:
- Actions taken by the State Medical Board
- Actions taken by Hospitals
- Criminal convictions
- Administrative actions
If a physician or dentist have an action, please read the attached PDF to determine its nature. An action is not necessarily the result of wrong doing or negligence.
We do not report malpractice claims. However, if a claim of malpractice is included in the state medical board action documents then those claims will be reported. If criminal convictions are available we will report them as well.
If we are not able to verify all components of a physician or dentist profile, we eliminate the record from our database. We feel that this provides the most comprehensive and accurate use of our data. UCHC does not claim to have all physicians and dentists in our database. However, the vast majority of all practicing physicians and dentists are properly profiled in our database.
UCHC provides physician and dentist reports in a format that allows for easy comparison of physicians and dentists. Our reports include demographic, professional, educational, and disciplinary information and areas of specialties. All information is delivered in a tabular format, with all definitions clearly described for the user. See the "Sample Physician or Dentist Comparison Report" for more details.
UCHC does not rate hospitals. There are many factors that affect quality care, and different conditions require different expertise. We provide you with the relevant quality measures and information that will allow you to pick what is important to you and give you a general perspective of quality, capabilities, and services of each hospital.
Facility information comes from the Provider of Services (POS) Extract and is compiled from the Online Survey and Certification Reporting System (OSCAR) database. These data include provider number, name, and address and provides detailed characteristics about the participating institutional provider. The data are collected through the Centers for Medicare & Medicaid Services (CMS) Regional Offices. The file contains an individual record for each Medicare-approved provider and is updated quarterly.
While many hospitals collect information on patient satisfaction, there is no national standard for collecting or publicly reporting this information that would enable valid comparisons to be made across all hospitals. In order to make "apples to apples" comparisons to support consumer choice, it is necessary to introduce a standard measurement approach. HCAHPS is a core set of questions that can be combined with customized, hospital-specific items to produce information that complements the data hospitals currently collect to support internal customer service and quality-related activities.
Three broad goals have shaped the HCAHPS survey. First, the survey is designed to produce comparable data on patients' perspectives of care that allows objective and meaningful comparisons among hospitals on topics that are important to consumers. Second, public reporting of the survey results is designed to create incentives for hospitals to improve quality of care. Third, public reporting will serve to enhance public accountability in health care by increasing the transparency of the quality of hospital care provided in return for the public investment. With these goals in mind, the HCAHPS project has taken substantial steps to assure that the survey is credible, useful, and practical. UCompareHealthCare uses two of the results from these surveys in our reports. The first question relates to how patients rate the hospital overall and the seconds relates to if that patient would recommend the hospital to a friend or family member.
Data for Mortality Rates are the rates at which people at specific institution die from a specific condition and are publicly reported risk-adjusted, 30-day mortality rates. CMS has indicated that in the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare & Medicaid Services (CMS) and Hospital Quality Alliance (HQA) have began publicly reporting 30-day mortality measures for acute myocardial infarction (AMI) and heart failure (HF) and for pneumonia (PN). A team of clinical and statistical experts from Yale and Harvard University developed these 30-day, risk-standardized mortality rates for these three (3) measures. These measures comply with standards for publicly reported outcome models that have been endorsed by the American Heart Association and the American College of Cardiology. These measures have also been published in peer review literature and approved by the rigorous process of the National Quality Forum. The purpose of reporting these measures is to focus attention on the patient's outcome of hospitalization. Publicly reporting the mortality measures provides hospitals, patients, and other consumers a tool to recognize quality improvement efforts made by the hospitals. All rates are calculated from Medicare claims data and hospitals are not required to submit additional data.
"Readmission" is when a patient has had a recent stay in the hospital and goes back into the hospital again. UCHC graphically shows how often patients are readmitted within 30 days of discharge from a previous hospital stay for heart attack, heart failure, or pneumonia. Patients may have been readmitted back to the same hospital or to a different hospital or acute care facility. They may have been readmitted for the same condition as their recent hospital stay, or for a different reason. UCHC shows how different hospitals' rates of readmission for heart attack, heart failure, and pneumonia patients compare to the U.S. National Rate. You can see whether the 30-day risk-adjusted rate of readmission for a hospital is lower (better) than the national rate, no different than the national rate (within the band), or higher (worse) than the national rate, given how sick patients were when they were admitted to the hospital. For some hospitals, the number of cases is too small (fewer than 25) to reliably tell how well the hospital is performing, so no comparison to the national rate is shown.
UCHC has obtained the stated readmission rates from CMS and displayed those rates with the objective of demonstrating how patients transition from the hospital to the next level of care. CMS has begun to look at issues in the Care Transitions Project within the Quality Improvement Organizations 9th Statement of Work. This project tasks Quality Improvement Organizations in 14 states to work to coordinate care and promote seamless transitions across settings, including from the hospital to home, skilled nursing care, or home health care. It also specifically focuses on reducing unnecessary readmissions to hospitals that may increase risk or harm to patients and cost to Medicare. Measures arising from this scope of work are geared towards achieving these goals of improved transitions of care and greater coordination among providers. In essence, these measures are breaking down the traditional silos and shifting focus to the continuum of care.
Focusing on coordination and integration across the care delivery system could allow for greater quality with fewer "hand-off" errors and less unnecessary, duplicative testing. It would likely mirror more accurately a patient's actual experience and could resonate more with them. With a broader view, it becomes possible to view a patient's care in context and address issues that stretch beyond any single care setting or entity. This is especially true for chronic diseases and end-of-life issues, accounting for a large number of Medicare beneficiaries.
When combined with the proper incentives, whether financial or non-financial, the use of quality measures could foster better transitions and coordination of care in two ways. First, such "transition measures" may expand the unit of measurement, whether the timeframe or the number of actors. For instance, instead of measures that look only within a specific hospitalization, a transition measure looks at a specified period of time before and/or after that hospitalization such as hospital readmission or 30 day mortality, events taking place outside the timeframe of the actual hospitalization.
Beginning in March, 2008, the Centers for Medicare & Medicaid Services (CMS) began collecting information about selected inpatient hospital stays provided to Medicare patients. This information shows how often Medicare patients were admitted to the hospital for specific conditions and what Medicare pays for those services to the hospital. This information will provide you with insight into the quality of the health care that is available at your local hospital and what Medicare pays for those services. This information will provide you with the opportunity to see how hospitals are delivering care to their patients through nationally standardized process of care and outcome measures, and cost information for individual hospitals. All of which can help you make informed choices when selecting a hospital.
The pricing and volume information contained and the graphic depiction of this data reflects inpatient hospital services provided by hospitals under the Inpatient Prospective Payment System (IPPS) to Medicare beneficiaries. This information is shown for several Diagnosis Related Groups (DRGs). DRGs are payment groups and patients who have similar clinical characteristics and similar costs are assigned to a specific DRG. The DRG is associated with a fixed payment amount based on the average cost of patients in the group. Payment information is displayed for 18 DRGs currently.
The state amount shown is the range of payments (between the 25th percentile and the 75th percentile) for the most typical cases treated in the area. This payment information does not include atypical cases that received substantially higher or lower payments than are common for the DRG and only one number appears in the field when the 25th and 75th percentiles are the same.
The pricing and volume information can provide users with a general overview of hospitals experience with the DRG's and cost. A better understanding of the cost of care leads to more informed decision making, one more way beneficiaries can help improve the longer term financial health of the Medicare program.
It's important to remember that this information does not replace talking with the patient's provider nor should it serve as the only source of information when selecting a hospital.
Process of care measures show how often hospitals give recommended treatments known to get the best results for patients with certain medical conditions or surgical procedures. Information about these treatments are taken from the patients' records and converted into a percentage. This is one way to compare the quality of care that hospitals provide to patients.
Nursing Home Information
UCHC's information on nursing homes is based on data collected by the federal government, as well the Centers for Medicare & Medicaid Services (CMS) online survey, The American Health Association's Online Survey Certification and Reporting (OSCAR) database, and the Minimum Data Set (MDS), which is part of the federally mandated process for clinical assessment of all residents in Medicare- or Medicaid-certified nursing homes. UCHC updates its database every three months from the CMS sources.
No, we do not rank, rate or otherwise grade nursing homes. We provide detailed information on each nursing home that allows you to make relevant decisions based on your individual circumstances.
UCHC nursing home data include information on nursing homes that are Medicare or Medicaid certified. These nursing homes provide skilled nursing care. There are many other types of facilities that provide various levels of health care and assistance with activities of daily living. Many of these facilities are licensed only at the state level. In addition, some nursing homes that provide a full range of care, including skilled nursing services, choose not to participate in Medicare or Medicaid. For information about any facility not found in this database, you should contact your state survey agency.
Your Nursing Home Comparison Report includes information on location and services offered, number of beds and number of nurses, quality measures, inspection results and ownership information. This is presented in a comparative format; you can compare up to four (4) nursing homes at a time.
We report on regulatory requirements that the nursing home failed to meet. We do not include the entire inspection report. The detailed inspection report (form HCFA-2567) contains the specific findings that support the state's determination that the requirement was not met. A complete inspection report and the nursing home's corresponding plan of correction to address the deficiencies found during the inspection are available from the state survey agency or from the nursing home itself.