- The CMS released its Overall Hospital Quality Star Ratings Wednesday despite continued industry criticism that the system's underlying methodology remains flawed.
- The results, which were also recently teased by CMS' announcement that 102 hospitals had earned the highest rating of five stars, aim to help consumers more easily compare hospitals by summarizing quality measure data into a single-star rating for each hospital.
- The release had been delayed from its originally scheduled date in April following pressure from 225 House members and 60 senators, and although the CMS said this update followed "substantive discussions" with stakeholders, numerous hospitals and industry groups -- as well as some federal lawmakers -- had continued to press for further delay.
The new Overall Hospital Quality Star Rating will include 64 of the more than 100 measures displayed on Hospital Compare.
In addition to the 102 five-star hospitals (out of 4,599 total hospitals), the ratings broke down as follows:
- Four stars: 934 (20.3%)
- Three stars: 1,770 (38.5%)
- Two stars: 723 (15.7%)
- One star: 133 (2.9%)
The argument against the ratings is they oversimplify complex data and thereby convey misleading information that can harm reputations and reflect unfairly on certain hospitals.
A statement Wednesday by the Association of American Medical Colleges argued the current methodology fails to account for differences in patient populations and the complexity of conditions handled by teaching hospitals, resulting in many leading institutions receiving lower ratings than some hospitals treating less complex conditions or limited to treating only certain conditions. This could drive patients away from hospitals that would actually be the best for their conditions, the AAMC said.
"Through these star ratings, CMS has implied that hospitals have been measured on an equal basis and that the comparisons are fair, an assumption that is unfortunately not true," the AAMC said.
Rep. Kathleen Rice (D-NY), who had introduced a bill earlier this week seeking to delay the release of the ratings for another year, stated she is working on a bill to "rescind the ratings for a year," Modern Healthcare reported.
A new CMS blog, meanwhile, indicates that its delay in releasing the ratings was used to "give hospitals additional time to better understand our methodology and data" and to allow the CMS to conduct outreach to hospitals.
Among the agency's responses to industry criticism are that "most" of the quality measures used in the ratings have already been adjusted to account for the illness-burden of the population, and that as far as the matter of making adjustments to account for sociodemographic characteristics, "We continue to work closely with the National Quality Forum and the Assistant Secretary for Planning and Evaluation (ASPE), who is required by the IMPACT Act to study the effect of socioeconomic status on quality measures and payment programs based on measures," the agency said. "We will work with ASPE and determine what next steps, if any, should be taken to adjust our measures based on the recommendations in the report."