Feds issue controversial star ratings for hospitals

Feds issue controversial star ratings for hospitals
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The Centers for Medicare and Medicaid Services (CMS) on Wednesday unveiled a simplified star-based rating system for hospitals, a controversial move that sparked opposition from both industry groups and lawmakers.

The Overall Hospital Quality Star Rating seeks to summarize the ratings CMS has issued for healthcare providers over the past decade, combining 64 of 100 existing metrics into one rating.

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Hospitals will be given one rating, ranging from one to five stars. The change is meant to make quality scores easier to understand for consumers visiting CMS’s Hospital Compare website.

But hospitals say the methodology unfairly penalizes educational institutions or those which serve low-income populations.

Hospital groups successfully lobbied the agency in April to delay the ratings that were slated to be released that month but failed to secure a second delay.

At that time, 225 House members and 60 senators wrote letters to the CMS, but they have remained mostly mum on the agency’s plan to release them this month.

On Monday, Reps. Jim Renacci (R-Ohio) and Kathleen Rice (D-N.Y.) introduced H.R. 5927, a measure to delay the ratings until July 2017 and to require a 60-day comment period on the ratings’ data and methodology.

The agency defended its work, claiming that research shows higher-rated hospitals have lower readmission and death rates. The CMS also said it took industry concerns about the differences between hospital types and sizes into consideration after the initial delay.

“CMS’s analysis shows that all types of hospitals have both high performing and low performing hospitals,” the agency said in a statement. “In other words, hospitals of all types are capable of performing well on star ratings and also have opportunities for improvement.”

But the American Hospital Association, America’s Essential Hospitals, and the Association of American Medical Colleges penned a letter on July 7 to CMS official Patrick Conway, claiming they have received “virtually no additional information” since March on how hospital type, demographic factors and patients with multiple chronic conditions would affect their ratings.

“The agency provided additional information on how it calculates and assigns star ratings, but far too little information on whether the methodology gives a fair and accurate appraisal of the true quality of care provided in America’s hospitals,” the groups said.

Overall, 102 hospitals, or 2.2 percent, received the full five stars; 934 (20.3 percent), earned four stars, 1,770 (38.5 percent) earned three stars, 723 (15.7 percent) received two stars and 133 (2.9 percent) earned one star. The CMS did not include ratings for 937, or 20.4 percent, of hospitals due to incomplete data.

The agency has said it is committed to improving the ratings for hospitals and other healthcare organizations. At a hearing earlier this month, CMS acting Administrator Andy Slavitt said the Office of the Assistant Secretary for Planning and Evaluation is working on a report, due in September, that would examine how the aforementioned factors impact ratings on Medicare Advantage plans.