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“What can we do to take the lessons from the high-performing institutions and help the low performers improve?” Jha asked. In markets outside of health care, business closures don’t so directly affect people’s survival, he said, but “here, there are tens of thousands of lives at stake.”

With the health law’s expansion of insurance in 2014, patients may have more choice in hospitals. But most patients don’t use tools like Hospital Compare to find the best ones nearby, Jha said. Hospital Compare is a government website that rates how hospitals measure up to certain standards, such as giving heart attack patients aspirin.

“People go to hospitals because they’ve always gone there or their families have always gone there or their doctors have always referred them there,” Jha said.

Nancy Foster of the American Hospital Association said the group is worried about whether the new funding formula will put safety net hospitals at financial risk, but believes all hospitals can improve.

“There’s no hospital in the country right now that doesn’t want to do the best for the patients it serves,” Foster said. “That’s where research comes in and sharing of good results on how to improve.”



Hospital Compare:

Health Affairs:


AP Medical Writer Carla K. Johnson can be reached at