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BALTIMORE – RESPONDING TO PERSISTENT provider complaints of inadequate risk adjustment in its public scorecards, the Centers for Medicare & Medicaid Services (CMS) announced that HospitalCompare and PhysicianCompare will now take into account whether hospitals and doctors were “unlucky.”

The move followed a recent article in the New York Times explaining the use of “luck” by “advanced basketball analysts.” The statistic, invented in the 1990s by Dean Oliver, currently vice president for data science at TruMedia Networks, is meant to account for a team’s wins and losses in certain very close games.

For years, doctors have said, ‘The operation was a success, but the patient died,’” explained CMS spokesman Nick “the Greek” Stephanopoulos. “We decided they were right.

Stephanopoulos said “luck” could also explain why as many as 400,000 patients die each year from so-called “preventable” medical errors in hospitals, even though it’s widely known that Americans get the best possible medical care.

Just like the best-coached team in the world can lose a close game on an opponent’s shot that bounces through the basket at the last minute, patients can get an infection, suffer an adverse drug reaction, have a sponge left in their body or get the wrong leg cut off despite receiving the best medical care in the world,” Stephanopoulos said. “To use a sports term, that’s just the way the ball bounces.

Stephanopoulos cautioned that the exact nature of medical luck was still being studied, so CMS can’t determine which members of the medical team are responsible for how much luck. As a result, the agency cautioned hospitals against misleading advertisements such as, “C’mon and get lucky with our nurses.”

Overriding objections for consumer groups, CMS said its newest version of HospitalCompare and PhysicianCompare would show that all hospitals and doctors were above average. A spokesman for the American Hospital Association said of the patient complaints, “They’re just sore losers.”

Michael Millenson
Michael L. Millenson, president of Health Quality Advisors LLC, is a nationally recognized expert on making American health care better, safer and more patient-centered. Michael is the author of the critically acclaimed book, Demanding Medical Excellence: Doctors and Accountability in the Information Age, and he is also an adjunct associate professor of medicine at Northwestern University’s Feinberg School of Medicine. Earlier in his career, he was a health-care reporter for the Chicago Tribune, where he was nominated three times for a Pulitzer Prize. A respected presence in health policy and strategy, Michael has lectured at the National Institutes of Health and the Harvard Business School and served as a faculty member for the Institute for Healthcare Improvement. He has testified before Congress and written for publications ranging from the British Medical Journal and Health Affairs to The Washington Post and Michael has consulted with policymakers and with a broad range of clients from all segments of the healthcare industry, providing services ranging from strategic planning to develop specific tools to improve care. He has served on the advisory board of several healthcare start-ups and currently serves in an advisory capacity to the American Journal of Medical Quality and the Lundberg Institute.


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