If you thought the delay of the release for Medicare’s star ratings meant the program was being shelved permanently, think again: The Centers for Medicare & Medicaid Services (CMS) has just announced more information about its new star ratings – including a breakdown of where many hospitals fall.
In a data brief about the ratings system, CMS goes into detail about how it’s ranking hospitals.
According to the agency, the new star rating is designed to provide a more comprehensive look at the quality of care a facility provides. It takes the current quarterly star rating, which the agency implemented last year, and factors in additional elements.
To come up with each hospital’s ranking, the agency used 62 of its existing quality measures and summarized the results of each.
Quality measures selected included those covering everything from rates of hospital-acquired infections to routine care during treatment for pneumonia or heart attacks. Procedures such as hip replacement surgery and MRIs are also factored into the score.
How hospitals did
CMS has already generated star ratings for thousands of hospitals. The new ratings have just been posted on its Hospital Compare website, and the data brief shows how the hospitals it’s rated are measuring up.
The bulk of the hospitals reviewed by CMS (1,770, or 38.5%) received three-star ratings for their care. Only 102 hospitals (2.2%) earned five-star ratings, but a much higher percentage (20.3%) received a four-star rating. Close to 3% of hospitals received a one-star rating, and almost 16% of hospitals earned a two-star rating.
While smaller or rural hospitals feared they may end up with low rankings due to their size, CMS said that wasn’t the case. Its data showed that size didn’t make a significant difference in how well a hospital ranked. Small, medium and large hospitals were all well represented in each rating category.
And critical access hospitals actually had higher scores than other facilities. The mean star rating for critical access hospitals was 3.31, while it was 2.99 for other hospitals. However, no critical access hospitals earned five-star ratings (though none of them received one-star ratings either).
Flaws in ratings
Although CMS controlled for certain characteristics of hospitals and their patient mixes, including how ill patients were, it didn’t closely consider patients’ socioeconomic status, according to an article from Kaiser Health News.
Per the CMS data brief, safety-net facilities ranked slightly lower (mean score of 2.88) than non-safety-net hospitals (mean score of 3.09). Teaching hospitals also fared slightly worse than their non-teaching counterparts. The mean star rating was 2.87 for teaching hospitals, while non-teaching hospitals had a mean star rating of 3.11.
While safety-net hospitals didn’t perform badly overall, a further breakdown of the ratings reveals some performance gaps. According to analysis from Kaiser Health News, 22% of safety-net hospitals received an above average rating of either four or five stars. Meanwhile, 30% of all hospitals earned a four- or five-star rating. And while 22% of hospitals received below average ratings of one or two stars, 29% of safety-net hospitals had below-average scores.
Similar disparities occurred with teaching hospitals, which means many prestigious facilities that rank highly on other lists (including the annual rankings from U.S. News & World Report) don’t have high ratings from CMS.
And some hospitals aren’t even rated at all. A significant portion of hospitals CMS examined (937 total, or 20.4%) didn’t receive a rating because these facilities didn’t meet the minimum quality reporting threshold requirements set by the agency.
Due to these issues, the ratings may not give a full impression of the quality of care a facility provides.
But regardless, they’ll soon be public knowledge. That’s why it’s critical for your hospital to know where it stands on the list – and to do what you can so these rankings don’t have a negative impact on your reputation or your bottom line.