Sixty senators signed a letter urging CMS to delay the scheduled April 21 release of its overall hospital quality star ratings, warning that the methodology might not accurately measure hospital quality.
The senators "support the public reporting of provider quality data," but they say that the current ratings system "may not accurately take into account hospitals that treat patients with low socioeconomic status or multiple complex chronic conditions."
As a result, the senators write, highly regarded hospitals that perform complex procedures and treat the sickest patients could receive only one or two stars on the five-star scale.
How CMS will decide if your hospital gets 'five stars' for quality
The letter also criticizes CMS officials for not disclosing enough information about how they create the ratings, with the senators noting that hospitals are "unable to replicate or evaluate CMS's work to ensure that the methodology is accurate or fair."
House lawmakers are collecting signatures for a similar letter, AHA News reports.
Only 87 hospitals expected to receive five stars
The letter comes after CMS in January detailed the methodology behind the overall hospital quality star ratings. The agency said it planned to post overall ratings for 3,647 hospitals—out of 4,604 hospitals in the Hospital Compare dataset—that met reporting criteria. Under the methodology, CMS said:
- 87 qualifying hospitals (2.4 percent) earned five stars;
- 821 hospitals (22.5 percent) earned four stars;
- 1,881 hospitals (51.6 percent) earned three stars;
- 716 hospitals (19.6 percent) earned two stars; and
- 142 hospitals (3.9 percent) earned one star.
The agency said hospitals can confidentially preview their star rating via CMS's QualityNet portal (AHA News, 4/11; Diamond, "Pulse," Politico, 4/12; Senate letter, 4/11).
From our expert: How to think about hospital rankings
The glut of ratings raises two questions. First, is anyone paying attention—beyond largely ambivalent hospital executives?
And second, how much should hospitals care about these rankings?
In an interview with the Daily Briefing, Alicia Daugherty discusses the Advisory Board's research on rankings, addresses some of the criticism that these systems have received, and touches on whether a good rating can lead to a return on investment.
READ THE Q&A
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