Why would I be? That's not my job. We don't use that stuff to make clinical decisions. We can't. We base ourselves off the scientific literature, which (again) relies on overall survival, not O/E mortality ratios. Perhaps some paper pushers somewhere use those when they first come up with the billing codes? But after that, we (and the rest of the industry) work around those billing codes to deliver the best treatment according to outcome-based research.

The mismatch between what the evidence tells us is the best treatment modalities, and what the paper-pushers argue about, is 75% of the problem of the US healthcare system.

How would we even measure observed mortalities, anyway? Cancer patients can die 30 years after discharge when they've moved 2 states away. The only ones we can observe are those on clinical trial protocols, who specifically agree to be part of a randomized trial and come back for followup on a regular basis. And even then - that can be tricky too, because of the long times involved.