CMS defends hospital star-rating program, plans only minor changes
Hospitals hoping that CMS will make drastic changes to its controversial hospital star-rating methodology might be disappointed, as the agency plans only some tweaks to the method in December, Modern Healthcare reported.
A CMS spokesperson told Healthcare Dive on Monday that the agency is planning to reconvene a technical expert panel this summer to review the methodology and assess any issues with potential changes.
The spokesperson defended how the star ratings are calculated, saying the method is "scientifically rigorous" and dismissing concerns from some providers that past ratings have put too much weight on some measures, skewing the results.
In a statement to Healthcare Dive, CMS said it will use the feedback from the panel this summer to enhance the methodology used for future start ratings. "Any recommendations from this panel would be made available for public comment prior to CMS making changes, as we want to ensure we are giving consumers the most useful information,” the spokesperson said.
CMS delayed a July release of the ratings that used a new variable model the agency called a more reliable formula. However, the new model dramatically changed how a subset of hospitals performed on the star ratings, with some scores dropping or rising by two stars.
The spokesperson said CMS chose that variable model “because it’s based on a scientifically rigorous methodology, often used for composite or summary measurement, that maximizes the information available in our existing Hospital Compare data.”
The CMS representative said the methodology lets the agency retain the important scientific properties of individual measures while still making them more accessible through a star rating. “The methodology allows us to reflect quality at as many of those hospitals as possible by including as many measures as possible. It also accounts for consistency of performance, by assigning more importance to measures more highly correlated with other measures,” the spokesperson said.
The proposed change that was shelved in June raised the ire of health systems and organizations. A March report on the star ratings formula alleged that it favored specialty hospitals over major teaching hospitals. After the CMS delay in June, Chicago-based Rush University Medical Center researchers also claimed that the agency miscalculated hospital star ratings. Rush said the agency relied more on one measure rather than weighing all eight in the safety-of-care group equally in the first four releases of the ratings. CMS additionally weighed too much on complication rates from hip and knee replacements in the most recent release, Rush University Medical Center researchers alleged.
The agency rejected the Rush claims as inaccurate. “To our knowledge, no analysis to date has demonstrated any miscalculations, and the concerns expressed to date have been about known aspects of the public methodology,” the CMS spokesperson said.
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