QualityCounts® Inpatient Hospital Report – Frequently Asked Questions
Why is the QualityCounts® Inpatient Hospital Report important?
The cost and quality of health care are critical to Wisconsin businesses, consumers and the economy
as a whole. Members of the The Alliance® are looking for ways to rein in health care costs and
engage their employees to be more informed health care consumers
The QualityCounts Inpatient Hospital Report enables members of The Alliance to compare quality
and cost. And as you’ll notice, the report indicates that all hospital care is not the same and high
quality care doesn’t necessarily cost more.
Why did The Alliance create this report?
The QualityCounts Inpatient Hospital Report was developed in response to the needs of our members,
who are concerned about health care quality and the impact of rising costs. Alliance members
recognize that health care costs have been growing out of proportion to other wage and benefit
increases and threaten to hamper job creation and economic development in the region.
Alliance members understand that health care quality and safety issues are a driver of higher costs
and poorer outcomes for their employees and family members. As business leaders, they understand
that “what gets measured, gets improved” and so are committed to creating greater transparency and
accountability of health care quality and cost.
Research shows that publicly reporting the results of hospital care creates a powerful incentive for
hospitals to improve. Equally important, consumers deserve information on cost and quality that
allows them to make good decisions. The long-term goal of The Alliance is to create a market that
recognizes and rewards high-quality care, not just care at the lowest cost.
What does the QualityCounts Inpatient Hospital Report measure?
The report focuses on overall hospital performance as well as common clinical areas like cardiac,
surgical, and birthing care. Within these areas, the QualityCounts Inpatient Hospital Report compares
aspects of performance that are important to Alliance members — results like rates of deaths and
potentially preventable complications. Quality measures are presented alongside a representation of
cost to Alliance members to help people begin to understand and compare the value of health care.
How does the QualityCounts Inpatient Hospital Report measure quality and cost?
The QualityCounts Inpatient Hospital Report uses nationally recognized measures developed by such
organizations as the Agency for Healthcare Research and Quality (AHRQ) and The Leapfrog Group.
The report includes information on outcome measures, process and structure measures, and the cost to
Alliance members.
Outcome Measures
The report includes outcome measures that create an indication of an “end result” of how a hospital is
doing with regard to deaths, potentially preventable complications, and certain obstetrical procedures.
The report indicates how a hospital performed in a certain area compared to how they were expected
to perform, given how sick their patients were.
National experts believe comparing each hospital’s actual performance to their expected performance
is a fair way to measure things like deaths and complications. In general, some people are at higher
risk to die or have complications; and some hospitals treat sicker patients than others. Without this
type of comparison, those hospitals that treat sicker patients would be at a disadvantage.
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The QualityCounts Inpatient Hospital Report compares each hospital’s actual performance to their
expected performance, and if the difference between the two is statistically significant, they receive a
plus if performance was favorable or a minus if performance was unfavorable. Hospitals whose actual
performance was about what you’d expect receive an open circle.
Process and Structure Measures
In addition to measures about a hospital’s outcomes, the report also looks at the processes and
structures in place to prevent medical errors and the processes to treat patients who have heart failure.
Cost to Alliance Members
The cost to Alliance members represents the typical cost for an average patient in each area of care.
It includes only the hospital portion of the cost; it does not include the bill for doctors and surgeons.
This measure gives consumers a general sense of which hospitals tend to be more or less expensive
within each area of care.
What Makes QualityCounts different from other reports?
What we report:

QualityCounts includes mortality and complication measures that are not available anywhere else.

Our report employed progressive statistical techniques to index several AHRQ Quality
Indicator outcome measures into one easily understood statement of performance.

QualityCounts is the only report that uses contracted rates as the basis for cost info (all other
reports use billed charges). We specifically use Alliance rates, so individuals can better
understand what their costs might be.
How the information is presented:

We consulted with experts in public reporting, to use evaluable/easily understood formats for
reporting performance, such as:
▪ “plus”, “empty circle”, & “minus” for quality measures
▪ “$”, “$$”, & “$$$” for cost measures.

QualityCounts measures what people say they want to know; mostly outcomes (Kaiser
Family Foundation, 2004 report).
Based on the QualityCounts Inpatient Hospital Report, are there some hospitals we should
avoid?
The results in the QualityCounts Inpatient Hospital Report are not a guarantee of the care someone
will receive when they are in a hospital. The fact that a hospital received a plus or minus on a certain
measure doesn’t mean that someone will necessarily have a good or bad result. The results show how
a hospital tends to perform in areas that the current science conservatively allows us to measure. The
QualityCounts Inpatient Hospital Report looks at care over a 2-year time span, includes lots of
patients, and uses state of the art measurement methods. As such, these results can be used as a
reasonable indicator, though not a guarantee, of performance.
The information in the report should be considered among many factors when making a decision
about your health care. Other important elements include your physician’s level of experience and
success rate for the type of care you need.
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Your relationship with your doctor is important, too — you should be able to ask questions and get
answers that you understand. Considerations such as the location of a hospital or clinic also may
affect your choice of a provider.
In the report, ratings for some hospitals appear to conflict with their reputations. Which should
I believe?
Reputations are built on a variety of things, including public perception. Public perception can be
influenced by factors such as:

Personal experience – the same hospital can earn a good reputation from someone who had a
positive experience and a poor one from someone who did not.

Advertising and promotion – hospitals advertise and promote their unique skills to create
their own reputation.

Performance measures – some hospitals tout selective measures that do not reflect broader
quality performance.
What’s the difference among the types of hospitals in the report?
The report includes information on community hospitals and regional hospitals; however, the main
difference is in the type of service and capabilities of the hospital. Hospital type does not determine
quality of care — safe, high-quality care can be found in all types of hospitals.
Community hospitals are small to medium-sized hospitals. They typically provide general care for a
wide range of patients, but sometimes transfer very sick or badly injured patients to regional hospitals
for special care.
Regional hospitals are generally bigger hospitals that provide a wide range of services and may
receive patients who need special care that other hospitals can’t provide. Within this group, a hospital
designated as an Academic Medical Center (AMC) is one that includes a medical school and closely
affiliated educational and clinical institutions such as hospitals and physician faculty practice plans.
AMCs typically provide a broader range of treatment than most: from routine to highly complex care
using technology unavailable at other hospitals.
I think about choosing a doctor rather than a hospital. How can this report help with that
decision?
Generally speaking, doctors are affiliated with certain hospitals to which their patients are admitted if
they need hospital care. When choosing a doctor, check the quality and cost ratings of the hospital(s)
the doctor uses. Look for hospitals that perform well in the areas that are most important to you, and
use the QualityCounts report as one of the factors in your decision.
How else can I use the QualityCounts Inpatient Hospital Report?
You can use the information in the QualityCounts Inpatient Hospital Report to ask questions of your
physician and/or hospital. The information in the QualityCounts Inpatient Hospital Report is fairly
general. If you or a family member needs hospital care, you’ll want to ask more specific questions,
such as:
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
What is the track record of this hospital/this doctor/this surgeon for the type of care that I
need? What are the death rates, complications, infections, and readmissions for patients who
have had the type of care that I am going to have?

How does the doctor/this hospital track information about performance related to quality and
patient safety?

What steps is the doctor/this hospital taking to improve patient results?

What can I do as a patient to help ensure my results are good? How can I avoid infections,
complications, or readmission to the hospital?
Not all hospitals and doctors will be able to answer these questions, and some may seem surprised
that you ask. This type of consumer involvement is relatively new, but is growing as awareness of
quality problems as well as health care costs increase. The act of asking these kind of questions sends
a powerful signal that consumers care about quality and safety and that they expect their health care
providers to not only measure their performance, but to share their results.
For more information about the QualityCounts Inpatient Hospital Report, please visit thealliance.org/qualitycounts
Are there any resources for individuals who are not able to access the QualityCounts Report?
Those who are unable to access the report because they are not a member of The Alliance, may want
to visit other reports that are available. A complete list can be found on our website here: thealliance.org/other