Hospital quality scores are publicly available, but the extent to which they reflect patient safety remains controversial. This study compared measures from the Leapfrog Group, which incorporates mandatory publicly reported data and voluntary self-reported data to give each hospital a letter grade, to mandatory publicly reported data on the Medicare's Hospital Compare website. Investigators found that most Leapfrog voluntary scores were close to perfect. For hospitals that did not report the voluntary component of the Leapfrog score, they modeled how the hospitals' overall letter grades would change if they had self-reported different performance levels.

Voluntary Leapfrog SPS measures skew toward positive self-report and bear little association with compulsory Medicare outcomes and penalties. SPS significantly impacts HSS grades, particularly when lower SPS is reported. With increasing compulsory reporting, Leapfrog SPS seems limited for comparing hospital performance.

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