GRMC Ranks High for Patient Safety and Cost Efficiency

Two recent studies are showing how well Grinnell Regional Medical Center ranks in the state for patient safety and cost efficiency.

The Leapfrog Group, a national nonprofit group focused on patient safety, has graded 2,651 hospitals nationwide for their patient safety outcomes. The study looked at 26 measures such as hospital-acquired infections, injuries, falls, and medication errors.

In Iowa, 26 of the total 118 hospitals were graded and GRMC was one of five Iowa hospitals to earn an A. Nationally, The Leapfrog Group recognized 729 hospitals with an A grade, 679 hospitals received a B, and 1,111 hospitals were given a C. Beyond a C, 132 hospitals were labeled with “grade pending.”

In 2010, GRMC was named a Top Hospital by The Leapfrog Group.  The Leapfrog Group is a coalition of public and private purchasers of employee health coverage. Their mission is to work for improvements in healthcare safety, quality, and affordability. It is an independent advocacy group working with a broad range of partners, including hospitals and insurers. Members include Chrysler, FedEx Corporation, IBM, and Motorola, among many others.

The second study, conducted by Kaiser Healthcare News, ranks Grinnell Regional Medical Center seventh in the state of Iowa for cost-efficiency in caring for Medicare patients. A nationwide study completed by the Centers for Medicare and Medicaid Services ranked the state of Iowa as the ninth most efficient state in providing Medicare patients with healthcare. Medicare released their findings of the differences in cost both geographically and between hospitals of different sizes.

“What they found does not surprise us,” says Jack Fritts, GRMC’s chief financial officer. “We’ve been talking with our elected officials for years that we not only provide some of the highest quality healthcare in the country here in Iowa, but we provide that care at a substantial value.”

The study looked at the national mean cost for caring for an average Medicare inpatient visit. Using that mean, they created an “efficiency index.” An index of one means that Medicare spends about the same per patient at a particular hospital, as it does per patient nationally. This measure of relative cost effectiveness is an improvement over previous studies because it “normalizes” the data to eliminate differences due strictly to payment rates and it includes costs incurred 30 days after discharge from the hospital.

Hospitals were then ranked on either side of the efficiency index of one. The average efficiency index for Iowa was .91 and GRMC’s efficiency index was .87, well below the national mean.

“The current Medicare reimbursement system is a fee-for-service system,” says Fritts. “That means that Medicare pays when tests and x-rays are ordered. The system inadvertently rewards healthcare providers for usage. Now, Medicare is moving to a fee-for-performance system and we’ve known for a long time than when the system begins to pay for careful usage of healthcare while providing excellent patient outcomes, we would be at the top of the list instead of at the bottom.”

The results of this study could provide guidance for policymakers about what it means to provide cost-efficient healthcare and whether lower costs are tied to the quality of the care provided. This research provides some evidence that even with keeping costs low, up to 30 percent below the national average for GRMC, hospitals can provide outstanding patient care.

“Hospitals will be rewarded for their efficiency and for the quality of care they provide patients,” says Fritts. “Our goal has always been to provide the best healthcare and patient experience we possibly can in the most cost-effective way. Medicare and organizations like The Leapfrog Group are now starting to hold other hospitals to that standard as well.”