Dive Brief:
- CMS is delaying the release of hospital star ratings after identifying an error in one of the measures. The agency will push back the April star ratings update until July, according to a CMS spokesperson. Star ratings, a tool meant to compare hospital quality and performance, are typically updated and released quarterly.
- CMS said there was an error within the category of calculating whether hospitals are delivering timely and effective care. More specifically, there was an error in the calculation of the OP-10 measure results for 2021. That measure specifically attempts to identify whether hospitals are performing unnecessary or "double" scans on patients' abdomens.
- It's unclear what led to the error. The regulator said it will update 2021's OP-10 results to correct the mistake.
Dive Insight:
In a bid to make it easy for consumers to compare hospital quality and performance, the federal government devised a rating system to grade hospitals in which the best facilities can earn five stars and low performers earn just one star.
However well-intended, the ratings system has come with controversy. Providers have criticized the methodology, arguing it oversimplifies the complex metrics that go into one single score, raising questions about the usefulness for consumers. The American Hospital Association has said previously CMS' approach to the stars program "has been flawed from the outset."
The rating system analyzes a vast array of quality metrics reported by hospitals from mortality rates to patients' own experiences.
After much criticism, CMS revamped the star ratings methodology in 2021. In one of the more significant changes, CMS now calculates scores by taking an average of the measures instead of its prior complicated system that weighed certain metrics more heavily than others, which was part of its "latent variable modeling."
"These changes have made the star ratings easier to interpret, more insightful for hospitals working to improve their quality of care and more balanced in favor of high-priority topics, like infections," AHA said in a April 2021 statement.
Although hospitals' star ratings are not tied to payment, it's a program leaders are sensitive to.
"But even without money on the line, some hospitals' C-suites pay close attention to the star ratings — more attention than most patients give the CMS ratings," Ben Harder, managing editor and chief of health analysis for U.S. News & World Report, said. "Since those hospitals are likely to focus their quality improvement efforts on measures where they have the most opportunity to perform better, it's important that CMS take the time to fix any inaccuracies in its published quality metrics."