• David M Shahian, Frederick L Grover, Richard L Prager, Fred H Edwards, Giovanni Filardo, Sean M OʼBrien, Xia He, Anthony P Furnary, J Scott Rankin, Vinay Badhwar, Joseph C Cleveland, Frank L Fazzalari, Mitchell J Magee, Jane Han, and Jeffrey P Jacobs.
• *Department of Surgery and Center for Quality and Safety, Massachusetts General Hospital, Boston, MA †Division of Cardiothoracic Surgery, University of Colorado, Aurora, CO ‡Department of Cardiac Surgery, University of Michigan Health System, Ann Arbor, MI §Division of Cardiothoracic Surgery, University of Florida, Gainesville, FL ¶Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, TX ∥Duke Clinical Research Institute, Durham, NC **Starr-Wood Cardiac Group, Portland, OR ††Vanderbilt University, Nashville, TN ‡‡Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA §§HCA North Texas Division, Dallas, TX ¶¶Society of Thoracic Surgeons, Chicago, IL ∥∥Johns Hopkins All Children's Heart Institute, All Children's Hospital, St. Petersburg, FL.
• Ann. Surg. 2015 Sep 1;262(3):526-35; discussion 533-5.

ObjectivesTo evaluate participant characteristics and outcomes during the first 4 years of the Society of Thoracic Surgeons (STS) public reporting program.BackgroundThis is the first detailed analysis of a national, voluntary, cardiac surgery public reporting program using STS clinical registry data and National Quality Forum-endorsed performance measures.MethodsThe distributions of risk-adjusted mortality rates, multidimensional composite performance scores, star ratings, and volumes for public reporting versus nonreporting sites were studied during 9 consecutive semiannual reporting periods (2010-2014).ResultsAmong 8929 unique observations (∼1000 STS participant centers, 9 reporting periods), 916 sites (10.3%) were classified low performing, 6801 (76.2%) were average, and 1212 (13.6%) were high performing. STS public reporting participation varied from 22.2% to 46.3% over the 9 reporting periods. Risk-adjusted, patient-level mortality rates for isolated coronary artery bypass grafting were consistently lower in public reporting versus nonreporting sites (P value range: <0.001-0.0077). Reporting centers had higher composite performance scores and star ratings (23.2% high performing and 4.5% low performing vs 7.6% high performing and 13.8% low performing for nonreporting sites). STS public reporting sites had higher mean annualized coronary artery bypass grafting volumes than nonreporting sites (169 vs 145, P < 0.0001); high-performing programs had higher mean coronary artery bypass grafting volumes (n = 241) than average (n = 139) or low-performing (n = 153) sites. Risk factor prevalence (except reoperation) and expected mortality rates were generally stable during the study period.ConclusionsSTS programs that voluntarily participate in public reporting have significantly higher volumes and performance. No evidence of risk aversion was found.

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