Hospitals routinely perform life-saving services, and we are all grateful to the hospital staff for their excellent work. However, hospitals can also be dangerous places where mistakes can lead to permanent injury or even death.
The Leapfrog Group was formed in 2000 by large corporations that purchased employee health insurance. They wanted to ensure that their employees received safe hospital care. In 2012, they launched the Leapfrog Hospital Safety Score, which assigns hospitals a letter grade. Biannually, The Leapfrog Group analyzes this information and assigns hospitals a score of A, the highest score, and B, C, D, or F, the lowest score.
The grades are assigned based on the following:
- Performance measures that the Center for Medicare and Medicaid Services (CMS) tracks.
- Leapfrog’s voluntary survey of hospitals
- Information from other sources as needed
The Fall 2024 hospital safety grades are listed here for our area.
The grades are as follows:
- A score for nine hospitals
- B score for six hospitals
- C score for one hospital
The Leapfrog Group reports the risk of dying increases in direct proportion to the letter grade assigned, and the risk of dying increases compared to an A-rated hospital by:
- 34.9% for a B grade
- 87.7% for a C grade
- 91.8% for a D and F Grade
The fine print states that these are estimated annual deaths due to medical errors. The Leapfrog Group doesn’t measure mortality rates for certain procedures but instead provides estimates. The reported risk of dying is not measured but merely a guess, and this should be clearly stated.
A study was done in May 2014 to determine if grades matter in hospital safety scores. The study evaluated 30-day mortality and readmission rates for medical and surgical admissions. There were minimal differences in mortality or complication rates in hospitals rated A, B, or C, and there were no differences in hospital readmission rates among any of the hospitals. Ironically, the surgical complication rates were lowest in the D/F-rated hospitals versus the A, B, and C ones.
There are two explanations for the lack of correlation between the assigned grade and patient outcomes. The first is that approximately 30 percent of the measures used to determine the grade are self-reported and not audited. The second issue is that not all tracked measures are associated with patient outcomes.
The study concludes that patient outcomes are not significantly different for the 94.2% of hospitals given a passing grade (A, B, or C) and that the Leapfrog Group should consider moving to a Pass/Fail system.
The other issue with the Leapfrog Hospital Grading system is that it encourages hospitals with an A to advertise this to the community. A sliding scale licensing fee is charged, topping out at $29,900 for hospitals with 500 or more beds. This fee raises the question of why the Leapfrog Group charges a fee to those it assigned the top score and whether this is a conflict of interest. To put this into perspective, there is an Open Payments website that tracks payments to physicians from drug and medical device companies. The website was developed as it was felt the payments would compromise the integrity of physicians. In the last year, the average payment to physicians was $48!
The Centers for Medicare and Medicaid Services (CMS) also has a hospital rating system based on one to five stars. The Leapfrog Group and CMS recently published their ratings of nine hospitals in our area. As they analyze much of the same data, you would expect their conclusions to be in agreement. However, the ratings agreed in only three of nine hospitals. CMS rated three hospitals 20% lower and three hospitals 40% lower than the Leapfrog Group. This means that healthcare is not as simple as ABC but that many nuances are present.
When deciding which hospital to use for your care, it is prudent to check several rating systems, such as the Leapfrog Hospital Grade and the CMS star rating. The next step is to find which hospitals are in your insurance network.
Analyzing the performance of the various hospitals in your area of concern is essential.
The Leapfrog Group Hospital Grade provides additional information for the following areas:
- Critical care or Intensive Care Units
- Pediatric Care
- Maternity Care
- Complex Adult Surgery
- Elective Outpatient Surgery
- Care for Elective Outpatient Surgery Patients
This is an excellent resource for determining which hospital will meet your needs. For example, if you are pregnant with your second baby and your first was delivered at 26 weeks or 14 weeks early, you will want to deliver at a hospital with a full-service neonatal intensive care unit. Two hospitals in our area meet this criteria and are rated B by Leapfrog.
UF Jacksonville delivers 112 very low birthweight babies, and the recommendation is that hospitals deliver at least 50 to maintain excellence in care. They also have a C-section rate for first-time Mothers of 13.9% versus a recommended rate of 23.6% or less. The total number of babies delivered last year was 3,032.
Baptist Medical Center Jacksonville delivers 149 very low birthweight babies and has a C-section rate of 33.7% for first-time Mothers. The total number of babies delivered last year was 2,699.
Therefore, both hospitals are excellent choices. The one you choose will depend on the hospital your doctor delivers babies, whether it is in the network, its proximity to your home, and other personal factors.
Patient safety is essential to every physician and hospital.
Patients and their families must become educated about their healthcare needs and advocate for the safe, effective, and cost-effective provision of medical care.
Using hospital rating systems in conjunction with your physician’s advice will give you the greatest chance of receiving safe and effective hospital care.
