New CMS ratings: Fewer than 5% of hospitals named as 'five-star'

Most hospitals received a three-star rating

See the Advisory Board's take on this story.

CMS has awarded 155 hospitals a "five-star" rating on its Hospital Compare website, while more than 700 hospitals received just one or two stars.

The hospital rating system offers a star rating based on the 11 publicly reported measures in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which assesses patient experiences.

The agency released its first star ratings for hospitals in April and updated the ratings based on new HCAHPS data in July and October. The latest update, released last week, is based on HCAHPS survey results for the reporting period from April 1, 2014, through March 31, 2015.

How hospitals fared

In total, CMS awarded five-star ratings to 155 Medicare-certified acute-care hospitals of the 3,542 eligible hospitals. In addition:

  • 1,173 hospitals received four stars;
  • 1,510 hospitals received three stars;
  • 633 hospitals received two stars; and
  • 71 hospitals received one star.

CMS did not rate 1,110 hospitals because the agency lacked adequate patient experience data during the survey period.

The number of five-star hospitals represents the fewest of any update, even as the number of eligible facilities has stayed largely flat. By comparison, the agency awarded five-star ratings to:

  • 251 hospitals in April;
  • 336 hospitals in July; and
  • 207 hospitals in October.

However, the number of one-star hospitals also represents the fewest of any update. CMS rated 101 hospitals in April as "one-star," compared with 121 in July and 76 in October (CMS data, 12/10; CMS fact sheet, 12/10).

Hospital Star Rating Map
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Star ratings reflect HCAHPS surveys competed from April 1, 2014, through March 31, 2015, as displayed in the Hospital Compare update released on Dec. 10, 2015. Each hospital must have at least 100 completed surveys over a given four-quarter period and be eligible for public reporting of HCAHPS measures to receive a star rating.

The Advisory Board's take

Jessica Suchy, iRound for Patient Experience

It's not surprising that we see this distribution and both the lowest number of organizations receiving the one- and five-star ratings since the ratings' inception. Organizations scoring one star in the first iteration of the star scoring have really been putting forth significant effort to improve their service excellence for patients and families. We see the majority of hospitals falling in the three- to four-star range and needing to make more substantive changes to go from good to great.

While incremental improvement may keep them above their lower-ranging peers, going from good to great is more difficult. And organizations at the top must be committed to staying there and must have best practices hardwired in every single interaction with the patient and family.

To date, we have not seen too many organizations putting a strong emphasis on the star ratings because while this isn't their first round of ratings, it is still a relatively new process. It will take some time for hospital leaders to focus on the star ratings given all of the other patient experience metrics they are tracking. But as patients have more consumer choices in health care—and now an easier ratings system—available for determining their choices, we expect we'll see more emphasis on this rating in the the coming year.

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