Health Grades Specialty Excellence Methodology (Page 2)

Specialty Excellence AwardTM Methodology 2007 2

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Cardiac

The Cardiac specialty area rating is based on:

Coronary bypass surgery

valve replacement surgery

Coronary interventional procedures

Heart attack

Heart failure

Atrial fibrillation

The star rating for each of these procedures or diagnoses is determined by evenly weighting the individual
mortality ratings (inhospital mortality, inhospital + 1 month mortality, and inhospital + 6 month mortality). The
Cardiac specialty rating is determined by evenly weighting the cardiac surgical star rating (coronary bypass
surgery and valve replacement surgery), the medical star rating (heart attack, heart failure, and atrial
fibrillation) and the rating for coronary interventional procedures. To receive a rating in this specialty area, a
hospital had to provide coronary bypass surgery and have star ratings in four of the five other medical
issues based on MedPAR data.

Cardiac Surgery

The Cardiac Surgery specialty area rating is based on:

Coronary bypass surgery

valve replacement surgery

The star rating for each of these procedures is determined by evenly weighting the individual mortality
ratings (inhospital mortality, inhospital + 1 month mortality, and inhospital + 6 month mortality). The Cardiac
Surgery specialty rating is determined by the weighted average of coronary bypass surgery and valve
replacement surgery. To receive a rating in this specialty area, a hospital had to provide both coronary
bypass surgery and valve replacement surgery and have a star rating on at least one procedure based on
MedPAR data.

Critical Care

The Critical Care specialty area rating is based on:

Diabetic acidosis & coma

Sepsis

Pulmonary embolism

Respiratory failure

Leapfrog's criteria for ICU specialist staffing

HealthGrades first calculates the average star ratings for sepsis and pulmonary embolism for inhospital
mortality, inhospital +1 month mortality, and inhospital +6 month mortality. We then convert Leapfrog's ICU
specialist staffing to a numeric value. The Critical Care rating is a weighted average of these values plus the
respiratory failure. To receive a rating in this specialty area, a hospital had to have star ratings in all four
areas based on MedPAR data, plus have a rating in Leapfrog's criteria for ICU specialist staffing.

Health Grades - Specialty Excellence Methodology (Page 2)