CMS last week updated hospital quality star ratings on Medicare's Hospital Compare website and proposed revamping its current model for rating hospitals.
Want to see how your hospital performed? See our interactive star rating map.
The overall hospital star ratings are based on 57 quality measures across seven categories:
CMS for this year's ratings curbed the ratings' reliance on patient experience and put more weight on prompt care and readmission rates. CMS this year also did not apply the winsorization method to limit "extreme hospital outliers" in the data and "minimize their effect on the overall ratings." Instead, CMS used k-means clustering under which the agency repeatedly categorized hospitals into the five star-rating groups until the hospitals in each group were sufficiently similar to each other and distinct from hospitals categorized in other groups.
CMS said it continued to weigh each hospital's average score for each of the seven quality categories in the same way as in previous methodologies. Mortality, safety of care, readmissions, and patient experience each accounted for 22% of a hospital's overall score, while measures of effectiveness of care, timeliness of care, and efficient use of medical imaging each accounted for 4% of the overall rating.
Of the more than 3,724 eligible for a star rating:
CMS did not assign star ratings to 1,060 hospitals for which it lacked sufficient data, Modern Healthcare reports.
Separately, CMS in a 48-page request for comment asked for feedback on the agency's plan to revamp how hospitals are rated. The agency wrote that it is considering replacing its current model with a more explicit approach, such as using an average of the quality measurements on which the ratings are based. Specifically, CMS said it is considering whether to:
CMS in the request said the proposal is a "long-term" consideration, and any potential changes would not take effect until the 2020 quality reporting year or later. CMS is accepting public comments on the proposal through March 29.
Tom Nickels, executive vice president of the American Hospital Association (AHA), said CMS' "update has not addressed the major concerns about the methodology and usefulness of the star ratings." Nickels said AHA "appreciate[s] that CMS continues to seek comment on changes, but would have preferred the agency had waited to release these ratings until a more reliable methodology is in place."
Bruce Siegel, America's Essential Hospitals (AEH) president and CEO, said he "find[s] it unfortunate that CMS decided to publish hospital star ratings today … as the agency proposed changes that recognize ongoing flaws in the ratings methodology." He said, "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" (Morse, Healthcare Finance News, 2/28; Stein, Inside Health Policy, 2/28 [subscription required]; Castellucci, Modern Healthcare, 2/28; Knowles, Becker's Clinical Leadership & Infection Control, 2/28; AHA statement, 2/28).
CMS Star Ratings are notoriously complex, but leaders at Rush University Medical Center have cracked the code.
Join this webinar on Tuesday, March 12 at 1 pm ET to learn the ins and outs of the rating system, including flaws in the methodology that could be negatively impacting your institution--and what you can do about it during the public comment period this month.
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