CMS star rating system coming "shortly"

Medicare patients who are trying to pick a provider will soon have a more straight-forward, visual way to compare nearly 4,000 hospitals. CMS will assign each hospital an overall rating of between one to five stars, the distribution of which it announced in a statement July 21.

The agency announced that the full implementation of the program would begin “shortly,” though the system has been in effect in less comprehensive ways since April 2015. The ratings will be visible on the section of the Medicare.gov site called Hospital Compare, where beneficiaries can search for hospitals by name or ZIP code. This method is meant to be a more comprehensive way of rating hospitals instead of requiring Medicare beneficiaries to wade through dozens of classifications one by one.

The ratings take 62 individual metrics and condenses them down into one quick at-a-glance grade. The overall grades come from comparing metrics such as rates of post-surgery infections, average Emergency Room wait times, hip replacement complication incidents, post-heart attack re-admittance and average number of CTs or MRIs a patient could undergo.

In what they said was an effort to “further CMS’s commitment to transparency,” the agency released a breakdown of the Overall Hospital Star Ratings. They said there were hospitals that earned ratings across the star spectrum among differently categorized institutions, seeming to adhere to statistical expectations.

For example, between 2 and 3 percent of all hospitals were given one- and five-star ratings. The most-awarded rating was three stars, at about 39 percent. Approximately 20 percent received four stars, while about 15 percent were given two stars.

That trend seemed to hold along most classification lines. The mean rating for hospitals of all bed sizes was between 2.8 and 3.2 hospitals (with smaller hospitals having a slight advantage). And the mean rating for teaching hospitals was about 2.9 stars, while non-teaching hospitals received about a 3.1. Similar trends shone through for hospitals broken down into CAH and non-CAH, DSH payment eligible and non-DSH payment eligible and safety net status and non-safety net status categories.

The agency’s statement said this means that the star rating will not unfairly favor some kinds of hospitals over others, and that Medicare beneficiaries should be able to find satisfactory hospitals based on these ratings among all types of institutions.”

“In other words, hospitals of all types are capable of performing well on star ratings and also have opportunities for improvement,” the statement said.

But not everyone was on board with the rollout, according to Kaiser Health News. Some parts of the healthcare industry, as well as many members of Congress, have come out against the new rating system, possibly because the new method loses some of the nuance of listing out the 62 specific ratings.

Other critiques from the Association of American Medical Colleges and the American Hospital Association include concerns about the system showing hospitals in wealthier areas as better, and docking points from certain prestigious hospitals, Kaiser reported.