The American Hospital Association (AHA) sent a 12-page letter to CMS Administrator Seema Verma Tuesday that asked her to suspend the “deeply flawed” hospital star ratings program. The AHA also offered a long list of desired “regulatory relief.”
In the letter signed by AHA Executive Vice President of Government Relations and Public Policy Thomas P. Nikels, the AHA called the ratings program a “regulatory burden” that is “substantial and unsustainable” for hospitals.
In addition to suspending the ratings program, the AHA gave a number of other suggestions, such as canceling Stage 3 of the meaningful use program, suspending the electronic clinical quality measure reporting requirements and using only "measures that matter" rather than the 90 hospital quality measures currently measured.
The quarterly star rating program creates a one-to-five star rating that CMS hopes will allow consumers to compare hospitals. Some groups have praised the program, but healthcare groups and leaders criticize it for being misleading and oversimplifying complex data. It also penalizes teaching hospitals and facilities that have poorer patients, critics say.
In its letter, the AHA questioned “the volume of recent regulatory activity,” which it said is not sustainable. In 2016, CMS and other HHS agencies released 49 hospital and health-system-related rules that comprise nearly 24,000 pages, according to the AHA.
“In addition to the sheer volume, the scope of changes required by the new regulations is beginning to outstrip the field’s ability to absorb them,” according to the letter.
The AHA said reducing “administrative complexity in healthcare would save billions of dollars annually and allow providers to spend more time on patients, not paperwork. CMS already has provided some important regulatory relief to hospitals, which we greatly appreciate.”
It shouldn't surprise anyone that AHA is asking to suspend the star ratings program. When CMS published the first ratings last July, AHA President and CEO Rick Pollack called the ratings program “confusing for patients and families" and said it raises more questions than answers. Just 2.2% of hospitals earned five stars, and the most frequent rating was three stars with 38.5% of hospitals.
There is little evidence on whether people look at hospital ratings when choosing where to seek care, but often they don't have a choice because of emergency circumstances or a lack of other nearby facilities.
In this week's letter, the AHA said CMS has created errors while executing the program, causing some hospitals to be incorrectly classified. The CMS has made a few changes to the program, including lowering the number of quality measures used, but provider groups have continued to push for the ratings to be delayed and reworked.
The star ratings aren't the only way consumers can find out about patient experience at hospitals. In 2015, Yelp announced a project with Pro-Publica that provides data like emergency wait times and reported deficiencies on the website. A recent study also showed that Yelp hospital reviews can be useful for people choosing providers.