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CMS Delays Release of New Hospital Star Ratings

April 21, 2016
by Rajiv Leventhal
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The Centers for Medicare & Medicaid Services (CMS) has delayed its plans to release its new quality star ratings for U.S. hospitals until July at the earliest.

Originally, CMS had planned to release a new star ratings system on Hospital Compare— a website designed for consumers to use in order to make healthcare decisions—on April 21. The current star ratings, which were released in April 2015, made public how hospitals rate on several quality measures, with a focus on the patient experience at Medicare-certified acute care hospitals. It uses data from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) measures that are included in Hospital Compare. The site showcases 12 HCAHPS star ratings on Hospital Compare, one for each of the 11 publicly reported HCAHPS measures plus a summary star rating that combines or rolls up all the HCAHPS star ratings.

The overarching goal of the overall hospital star ratings is to improve the usability and interpretability of information posted on Hospital Compare. But now, CMS has delayed the release of its new ratings system which was supposed to simplify the quality measures that hospitals are rated on into a unified rating of one to five stars, with five being the best.

Last month, the American Hospital Association (AHA) and other industry stakeholders wrote a letter to CMS pushing the agency to delay the release of the new system until July at the earliest. The letter wrote, “Due to our serious concerns that these star ratings will be misleading to consumers, we believe that a delay is necessary to allow CMS to fully understand the impact of the star ratings on all hospitals and to address the flaws in the measures and methodology.  In order to move forward, hospitals must be provided with the data that will enable them to assess the ratings and ensure they are accurate.”

The letter additionally stated that many of the nation’s best-known hospitals, institutions that serve low income and complex patients, and are highly rated in other quality rating reports, will be receiving 1 and 2 stars because the ratings rely heavily on measures, such as the PSI-90 composite and the hospital-wide readmissions measure, that MedPAC and other researchers have identified as being inappropriately risk adjusted. These ratings do not account for hospitals that serve highly complex patients with significant socioeconomic challenges, and that also perform a greater number of complex surgeries, the letter said.

According to an NPR report, 60 senators and 225 members of the House of Representatives additionally signed letters urging CMS to delay releasing the star ratings. In a conference call with hospital representatives, CMS officials said they might delay release of the ratings past July if they are still analyzing or revising the methodology, according to NPR.

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