CMS to implement Hospital Star Rating System

The US Centers for Medicare & Medicaid Service (CMS; Baltimore, MD, USA) is launching a new five-star quality rating system on its Hospital Compare website, which posts quality ratings for more than 3,000 US hospitals, based on adherence to basic clinical care guidelines and other information, such as patient experience scores, readmission rates, mortality rates, and complication rates.

The new quality rating system will be an average of the star ratings for each of the 11 publicly reported measures from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which evaluates patients' experiences at hospitals. Hospitals had the opportunity to preview their overall star rating in a dry run of the program in fall 2014. The first public reporting of the ratings in April 2015 will be based on patients discharged between July 1, 2013, and June 30, 2014.

The move is part of a broader initiative by the CMS to add the star ratings across all of its consumer-facing Compare Web pages to assist them in evaluating the quality of healthcare facilities; the first rollout, in 2008, began with star ratings given to nursing homes. In 2014, similar programs were implemented for home health providers, dialysis facilities, and large group practices. The rollouts were met with controversy over methodology, and a debate on whether the ratings added or eliminated confusion for patients. The American Hospital Association (AHA; Washington DC, USA) was one of those that expressed concerns about the ratings.

“A single star rating has the potential to oversimplify the information about quality that might be most relevant to patients,” said Akin Demehin, senior associate director of policy at the AHA, as quoted in the March 2015 issue of Modern Healthcare. “Frankly, if they arrive at a methodology that is a significant departure from what will be publicly displayed this month, it can actually lead to a great deal of confusion among providers and patients.”

The HCAHPS surveys are provided to a random sampling of patients within two days of discharge from a hospital, and must be completed within 42 days. The survey includes questions about the responsiveness of hospital staff, quality of care transitions, and how well information on medications is communicated. It also asks about the cleanliness and quietness of the facility and whether or not they would be willing to recommend it to others. Every day, on average, more than 8,400 patients complete the survey.

Related Links:
US Centers for Medicare & Medicaid Service
Hospital Compare website
American Hospital Association