Tuesday, 26 July 2016 06:34

CMS Unveils New Hospital Star Ratings

Written by Mark Spivey

A total of about 100 hospitals nationwide, out of thousands, achieved the coveted five-star rating from the Centers for Medicare & Medicaid Services (CMS) during its most recent analysis of performance metrics tracked on a quarterly basis.

The latest results were released via Hospital Compare, which CMS describes as “a consumer-oriented website that provides information on how well hospitals provide care to their patients … (that) can help consumers make informed decisions about their healthcare,” according to a post on the CMS website last week. CMS now has been posting quality star ratings based on patients’ experiences of care on Hospital Compare since April 2015.

CMS’s star rating system takes 64 existing quality measures already reported on Hospital Compare and summarizes them into a unified layout of one to five stars. The ratings reflect quality measures for routine care patients receive when being treated for ailments such as heart attacks and pneumonia as well as measures that focus on hospital-acquired infections, such as catheter-associated urinary tract infections.

Some other measures include:

  • How often do patients get an infection after surgery?
  • How long, on average, do patients have to wait in the emergency department before seeing a provider?                                                                                                                                   
  • How often do patients develop complications after hip replacement surgery?
  • How likely are patients to get readmitted to the hospital after a heart attack?
  • Will patients receive multiple CT scans or MRIs?

The 64 measures are separated into seven groups, including Mortality, Safety of Care, Readmission, Patient Experience, Effectiveness of Care, Timeliness of Care, and Efficient Use of Medical Imaging.

“This analysis furthers CMS’s commitment to transparency in the development and reporting of the Overall Hospital Star Rating,” the agency’s post read. “We hope that by releasing our analysis of the impact of the overall star rating on different types of hospitals, we are able to clarify our ratings and address any questions or concerns about the data from stakeholders.”                                                                             

The most recent CMS analysis of star rating measures illustrated, in the words of the agency, “that all types of hospitals have both high-performing and low-performing hospitals.”

“In other words,” the post read, “hospitals of all types are capable of performing well on star ratings and also have opportunities for improvement.”

While 102 hospitals in all achieved a five-star ratings, far more were included in the lower rungs. A total of 934 hospitals, more than 20 percent of the total, received four-star ratings, while 1,770 (38.5 percent) earned three-star ratings.

A total of 723 hospitals were rated at two stars, with 133 receiving only a single star.

The analysis also broke down the ratings by hospital size, with facilities of 1-99 beds,100-199 beds, and 200 or more beds all exhibiting remarkably similar breakdowns. The same was true when gauging the performance of teaching and non-teaching hospitals, according to the data.

“CMS (also) found that safety net hospitals (were) similar to but (received) slightly lower average ratings than non-safety net hospitals,” the CMS post read; hospitals were designated as such if a) the hospital was a public hospital; or b) the hospital was a private hospital with a Medicaid caseload at least one standard deviation above their respective state’s mean hospital Medicaid caseload, as ascertained from the American Hospital Association Annual Survey performed in 2013.

Furthermore, critical access hospitals (CAHs) received higher average star ratings than non-CAH facilities.

Details on the measures and groups that are used in determining CMS star ratings can be found online at www.qualitynet.org. For more information about this topic, go online to www.medicare.gov/hospitalcompare.

About the Author

Mark Spivey is a national correspondent for VBPmonitor.com. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..

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Last modified on Wednesday, 27 July 2016 12:20