Healthcare News & Insights

CMS delays updates to hospital star ratings: What’s next?

Good news: The Centers for Medicare & Medicaid Services (CMS) has announced that it’s postponed the release of its new star-ratings program for hospitals – and it’s planning on a few changes to make the methodology more accurate. 

484540333Last year, CMS updated its Hospital Compare site with five-star quality ratings that came from the results of patient satisfaction surveys.

This month, it was set to take additional information into account when calculating the ratings, including a facility’s 30-day readmission rate and patient mortality rates.

But, according to an article in NPR, this decision immediately received backlash from hospitals and healthcare officials. Here’s why: Many of the measures CMS chose to evaluate weren’t directly related to each other, which could paint an inaccurate picture for the general public of a hospital’s quality of care.

In addition, well-renowned facilities that treated a sicker or disadvantaged patient mix would be penalized for having higher readmission rates than average. Hospitals that earned national accolades for quality were in danger of receiving one or two star ratings under the revamped CMS system.

Hospitals were backed in their opposition by Congressional representatives, who signed letters encouraging CMS to postpone the release of its new star rating system. Facilities needed time to see if it could replicate CMS’ results using the agency’s methodology and make suggestions for improvement.

CMS responded – and it’s said it’ll delay its new star ratings until at least July. The agency said it’ll take suggestions from hospitals, healthcare executives and other stakeholders to improve its methodology.

What hospitals want

In a letter to CMS written before the delay was announced, the American Hospital Association (AHA) called on the agency to:

  • share all the data it uses to calculate the star ratings with hospitals before they’re released to the public so facilities can double-check the accuracy of CMS’ calculations
  • remove a composite measure from the methodology that evaluates hospitals based on their cumulative performance with a number of conditions (such as pressure ulcer rate, postoperative hip fractures and postoperative sepsis), and
  • adjust the star ratings to take socioeconomic and other demographic factors into account that are outside of a hospital’s control with patient care.

While CMS hasn’t said whether it’ll consider these specific suggestions, the agency’s seeking feedback about the ratings system. And it could delay the launch of the new ratings longer than July if it’s still working out any issues.

Accuracy is crucial

Per an article in Health Affairs, consumer interest in reviews and ratings systems for healthcare facilities is growing, so a government-endorsed star rating may end up holding a lot of weight for patients who treat health care as a financial decision.

But the ratings must be accurate and give patients information about areas they care about the most. According to the NPR article, 22% of the star rating CMS is currently considering is based on mortality, readmissions, patient experience and safety of care. But only 12% is based on timeliness of care, effectiveness of care and efficient use of medical imaging. These areas can be just as important to patients as their own personal satisfaction – or even more so, in some cases.

CMS plans to make more details about its star ratings system public – particularly the information and final criteria it’ll use to calculate each rating. We’ll keep you posted.

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