Tuesday, 20 October 2015 05:20

Report: HCAHPS Star Ratings Plunge

Written by Mark Spivey, VBPmonitor Correspondent

Hospitals nationwide are still getting used to the notion of being “star-rated” via the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) program, which compiles consumer feedback and scores providers as though they were restaurants coming under the scrutiny of Yelp reviews.

What comes with that territory is the disappointment of losing a star.

The number of five-star hospitals has dropped precipitously, according to a Becker’s Hospital Review analysis of a recent Centers for Medicare & Medicaid Services (CMS) update to its Hospital Compare database website, with the number of such facilities falling from 336 when gauging consumer feedback compiled from October 2013 through September 2014 to just 207 when only gauging feedback compiled last year alone.  

That marked a decline of approximately 38 percent. The good news was that the number of one-star hospitals dropped by approximately the same margin, going from 121 to just 76.

The HCAHPS program covers more than 3,500 hospitals in all, the vast majority of which are two-, three-, or four-star rated. The number of four-star hospitals also recently dropped slightly, going from nearly 1,300 to fewer than 1,100, while the number of three-star hospitals rose from 1,320 to 1,531. The number of two-star hospitals also climbed slightly, from 475 to 638.

CMS plans to update its data and hospitals’ star ratings on a quarterly basis going forward.

The intent of the HCAHPS initiative is “to provide a standardized survey instrument and data collection methodology for measuring patients' perspectives on hospital care,” according to the language of its website.

“While many hospitals have collected information on patient satisfaction, prior to HCAHPS there was no national standard for collecting or publicly reporting patients' perspectives of care information that would enable valid comparisons to be made across all hospitals,” the site reads. “In order to make ‘apples to apples’ comparisons to support consumer choice, it was necessary to introduce a standard measurement approach” – defined by the agency as a “core set of questions that can be combined with a broader, customized set of hospital-specific items.”

HCAHPS survey items complement the data hospitals currently collect to support improvements in internal customer services and quality related activities, CMS has said.

The HCAHPS survey contains 21 metrics, or “patient rating items,” that encompass nine key topics: communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, quietness of the hospital environment, and transition of care. The survey also includes four screener questions and seven demographic items, which are used for adjusting the mix of patients across hospitals and for analytical purposes. The survey is 32 questions in length.

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.