"It was a nice way to get the word out," said Janice Smith, director of women's services at the Iasis Corp.-owned facility. "It got more people aware that we have this new center. Our tour numbers have gone up. People want to see it now, and they may want to deliver here. It is new and nice."

Local media picked up on the story this summer, also propping up MountainView Hospital's maternity center. The HCA-owned hospital was the only other maternity center in the Las Vegas area to get five stars in "clinical excellence," plus it also received the more prestigious Excellence Award in maternity care.

At the bottom of the list were one-star recipients Spring Valley and Southern Hills hospitals, whose maternity centers rank in the lower 15 percent nationwide, according to HealthGrades' methodology.

But both of those hospitals scored better on overall quality at the Leapfrog Group.

Welcome to the growing world of health care quality scores.

The science of quality is becoming more mainstream, in a large part because of pushing by the federal government. On Aug. 22, President Bush issued an executive order telling four federal agencies to compile information on the quality and price of medical procedures — the latest in years of steps by the government in that direction.

Industry experts say the general public is slow to adopt the new way of thinking. People comparison shop for cars, but for hospitals and doctors? Pssh, the insurance company takes care of that.

But even insurance companies are pushing the cultural shift.

Anthem Blue Cross Blue Shield, a Denver-based insurer that covers both Colorado and Nevada residents, allows its members to check out success rates published by a company called Subimo.

"We're still a few years away from having enough credible information to start making network decisions based on quality results for certain procedures," said Joe Hoffman, Anthem's vice president and general manager for large groups. "What I really believe is that the consumers are going to have to help drive this as well. We're going to have to see a consumer demand for this information."

The trend seems to be fueled not by private companies, but rather by the federal Centers for Medicare and Medicaid Service and a private group that works with the government, the Joint Commission on Accreditation on Healthcare Organizations.

"(Quality tracking) has been part of the hospital industry and the hospital culture for many, many years," said Judy Mahoney, quality director at North Vista, who has been in hospital quality in the valley since 1993. "It's not new, it's just that these new public ratings have really made them (more visible). About three or four years ago, it really started changing."

Medicare started out slowly, asking hospitals to voluntarily submit — or lose some funding — how well they performed on a checklist of procedures, called Benchmarks. Scores are derived from answers to questions such as: "What percentage of heart attack patients were given an aspirin at discharge?" or "What percentage were given advice about how to stop smoking?"

Each hospital is ranked in these categories among more than 4,000 hospitals nationally. CMS published the results online starting in 2003, then unveiled the user-friendly www.hospitalcompare.hhs.gov in 2005.

All of this information feeds into for-profit rating agencies such as HealthGrades, which charges hospitals for the right to use their honors in advertising and marketing.

Scott Shapiro, a spokesman for the 7-year-old company, would not say how much HealthGrades charges for reprinting the data, which are free to the public via the Internet. The Colorado-based company with about 100 employees reported a revenue of $20.8 million in 2005, and a profit of $4.1 million, up from a profit of $1.8 million in 2004.

HealthGrades, which is allied with J.D. Power and Associates, also tracks its reach to the public through its Web site, Shapiro said.

"The traffic has topped 3 million individuals each month," Shapiro said. "That's an enormous amount of traffic. That's not page views or hits, that's 3 million individuals each month looking for hospital quality information, researching nursing homes or accessing the new cost reports we've put up."

Medicare-funded quality improvement organizations like HealthInsight, which serves Nevada, also use CMS figures. HealthInsight trains medical facilities to become more efficient. It also compiles Medicare data and ranks hospitals nationally: St. Rose Dominican Hospital-Rose de Lima Campus in July promoted its ranking as the highest-scoring facility in Nevada. Its Siena Campus followed at third, after Washoe Medical Center.

The government has just accomplished a smidgen of what it plans to do.

Already CMS is collecting its second round of data: patient satisfaction scores. Surveys went out this spring and should be published in 2007.

And cost comparisons are on the way, though the government does not have plans to force hospitals to publish their rates for hip replacements or heart bypasses.

In June, CMS first published average amounts of how much it pays hospitals for 30 common medical procedures. Clark County hospitals, for example, receive between $31,692 to $37,007 for each heart valve operation for someone covered by Medicare, compared with the national average of $38,528. That price is different for insurance companies that negotiate contracts and for uninsured individuals.

In the private sector, health insurer Aetna on Aug. 21 began publishing cost, quality and efficiency data for doctors in certain cities, not including Las Vegas.

The ramifications of this public reporting — also known as "transparency" — could mean major changes for the health care industry.

Dr. Ikram Khan, a retired physician who now runs Quality Care Consultants in Las Vegas, said some in the medical community are wary about the trend.

"I'm not so sure that the systems and the software are sophisticated yet to take everything into account," Khan said. "At least it's a step in the right direction, but my view is that (quality ratings) shouldn't be publicized so openly until the technology is available to take into account all factors that may have contributed toward an adverse outcome. It could be doing some injustice to the best-known organizations."

Hospitals typically measure their own success rates, he noted. In his perfect scenario, the government and private companies should give hospitals a couple of years to work out problems before reporting them to the public.

"The medical industry needs to be prepared to be critically analyzed in terms of the outcomes of their services," he said. "Once that is done, it will help not only the quality of care, but automatically cut the cost (because of reduced complications)."

But it's not just negative reinforcement that will drive changes in health care. Medicare and insurance companies like Anthem are starting "Pay for Performance" programs, in which money is kicked back to a hospital that has good quality scores.

"The best thing is that we're finding a lot of these hospitals that are reinvesting payments continue to improve quality that they deliver," said Hoffman, of Aetna.

Mahoney, the quality director at North Vista, said she expects hospitals will not make adjustments to their programs to chase the scores. Rather, the scores are a result of what the hospitals are really after.

"We're always looking for areas to improve," she said. "It doesn't make any difference when the ratings come out, we are already looking in those areas."