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Hospital star ratings released as CMS seeks to update methodology

Number of vulnerable patients, social risk factors, other issues beyond a provider's control, lead to misleading ratings, Essential Hospitals says.

Susan Morse, Senior Editor

The Centers for Medicare and Medicaid Services today updated hospital performance data through star ratings on its Hospital Compare website.

Hospital Compare uses quality measures to compare more than 4,000 Medicare-certified hospitals as well as Veterans Health Administration and Military Health System hospitals. Consumers may enter their zipcode to find star rating comparisons of hospitals within their area.

However, providers have told CMS the system is flawed, with hospital ratings changing for no apparent reason. Because of this, the last overall hospital star ratings were last updated in December 2017.

Today's report came out as CMS is proposing changes to answer those concerns. The changes under consideration are intended to respond to stakeholder feedback, CMS said.  

"We find it unfortunate that the Centers for Medicare and Medicaid Services  decided to publish hospital star ratings today even as the agency proposed changes that recognize ongoing flaws in the ratings methodology," said Dr. Bruce Siegel, president and CEO America's Essential Hospitals. "Those flaws contribute to ratings that mislead consumers and disadvantage hospitals that care for vulnerable patients, rather than reflect true hospital performance and improvement. The ratings also fail to account for social risk factors beyond a hospital's control and that affect performance."

THE IMPACT

As consumerism takes hold in healthcare, star ratings make a competitive difference.

The star ratings drive systematic improvements in care and safety as hospitals strive to achieve and maintain high ratings, CMS said.

"Consumers and patients point to Hospital Compare and the star ratings as important resources and rely on the latest data," CMS said. "Many hospitals rely on these ratings to identify areas for improvement."

WHAT ELSE YOU NEED TO KNOW

CMS is seeking public comment, due by March 29.

The agency wants to enhance the methodology by allowing more direct, "like-to-like" comparisons. One potential change, recommended by some hospitals, would place hospitals with similar characteristics into "peer groups" allowing small hospitals to be compared to other small hospitals instead of all hospitals.

Data used for star ratings includes specific measures of a hospital's quality of care.

Comparisons are made based on patient experience, the timeliness and effectiveness of care, complication rates, and other factors. Information is also organized by medical condition, such as heart attack, pneumonia, or type of surgery.

Before each update of Hospital Compare, hospitals can preview their data, including their star rating, for 30 days before updates are published.

ON THE RECORD

"The Hospital Compare website and Star Ratings System are valuable consumer tools that provide helpful and important information on the safety and quality of our nation's hospitals," said CMS Administrator Seema Verma. "These decision-making tools offer greater transparency on hospital performance for a wide variety of users – patients, caregivers, families, and the broader healthcare industry. We constantly aim to improve these resources with feedback from stakeholders, and we are confident this latest update of Hospital Compare data further strengthens this data."

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com

 

 

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