The Centers for Medicare & Medicaid Services announced it will not update its overall hospital quality star ratings on Hospital Compare in October. “CMS decided not to proceed with the October update to continue its examination of potential changes to the Star Rating methodology based on public feedback,” the agency said. The star ratings released last December will remain on the Hospital Compare website until the next update, CMS said.
Flawed Methodology and Hospital Criticism
When the ratings were posted in July 2016, they were heavily criticized by hospital groups and the Medicare Payment Advisory Commission (MedPAC) for “flawed methodology” and not accounting for socioeconomic factors in a hospital’s patient population.
The AHA has continued to ask CMS to suspend the star ratings until the “methodology is improved” and consider scrapping the overall rating for ratings separated by topic areas like patient safety, patient experience and cardiac care. “The measures included in the ratings were never intended to create a single, representative score of hospital quality,” wrote Ashley Thompson, AHA’s senior vice president for public policy, in a September 25 letter to CMS.
AHA has been a frequent critic of the star ratings program, saying it has “significant concerns about the conceptual underpinning” of the program and is concerned about the “reliability and accuracy” of the methodology used to determine the one-to-five star rankings. In June it asked the CMS to suspend the program entirely.
In general, hospitals have never been a fan of the star ratings program. CMS issued the first results in July 2016, and only 2.2% of hospitals received the full five stars. AHA has said some hospitals have been incorrectly classified, and that the ratings themselves are too simplistic, as well as misleading and confusing for patients. They also say the program puts too much regulatory burden on hospitals.
How Current Rankings Work
Each year hospitals that bill Medicare must complete a Hospital Consumer Assessment of Healthcare Providers and Systems Survey, also known as Hospital CAHPS, a survey designed as a standardized methodology for measuring patients’ perspectives on hospital care.
The ratings are relatively new. The first star rankings appeared on Medicare.gov in July 2016 and were updated in October. The star ratings are based on self-reported data points from each hospital encompassing 64 quality measurements in seven categories that include mortality, safety of care, readmissions, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging. CMS then uses an algorithm to assign a 1-5 star rating on about 3,700 hospitals nationwide, which consumers can view on the Hospital Compare section of Medicare.gov.