Will new star ratings for hospitals be an improvement?

Star ratings are now a way of life in many healthcare settings, but hospitals were recently given a short delay before the implementation of a new star system. Just one day before “overall hospital quality” ratings were set to launch in late April, CMS postponed the rollout in response to requests from Congress and the hospital industry.

The delay won’t leave patients without comparison tools, however. Hospitals are currently rated with a star system based on patient satisfaction surveys. While some say this approach is reductive, a study published in the Journal of the American Medical Association found that there is a relationship between these star ratings and the risk-adjusted mortality rates for a hospital. Therefore, patients who select a hospital using only the patient satisfaction stars would gravitate toward higher quality facilities.

CMS thinks it can improve, however. The new star system proposes to use data beyond patient surveys to paint a picture of overall quality. The system is based on 62 factors measured by CMS, with stars weighted in each of the following categories:

  • Mortality (22%)
  • Readmissions (22%)
  • Patient experience (22%)
  • Safety of care (22%)
  • Effectiveness of care, timeliness of care and efficient use of medical imaging (12%)

One of the hospital industry’s main objections to this model is that it says it has been unable to replicate CMS’s ratings (under which only 87 of the more than 3,600 hospitals in the country would have achieved a five-star rating).

In its initial announcement of the delay, CMS stated that it would implement the system in July, but it has since indicated it may push the date back even further if more study or revision is needed.

“CMS is committed to working with hospitals and associations to provide further guidance about star ratings,” the agency said in its announcement. “After the star ratings go live in their first iteration, we will refine and improve the site as we work together and gain experience.”

Time will tell what those refinements will look like, but for now, hospitals can use their extra time to ensure they are collecting high quality data and working to improve in the categories that will be weighed in the new system.