Over the strong objections of the hospital field, the Centers for Medicare & Medicaid Services (CMS) today released its new star ratings for hospitals on the Hospital Compare website.

“The new CMS star ratings program is confusing for patients and families trying to choose the best hospital to meet their health care needs,” said AHA President and CEO Rick Pollack. “Health care consumers making critical decisions about their care cannot be expected to rely on a rating system that raises far more questions than answers. And it adds yet another to a long list of conflicting rating and ranking systems … We want to work with CMS and the Congress to fix the hospital star ratings so that it is helpful and useful to both patients and the hospitals that treat them.”

The star ratings, released for more than 3,500 hospitals, came after a three-month delay due to concerns raised by hospitals and members of Congress about the program and methodology used.  The ratings are based on more than 64 quality measurements. The grading system gives hospitals a rating of one to five stars.

Reps. Jim Renacci, R-Ohio, and Kathleen Rice, D-N.Y., July 25 introduced a bill to delay for at least one year the introduction of the Centers for Medicare & Medicaid Services’ (CMS) new hospital star ratings to ensure the ratings are fair and reliable.

The Hospital Quality Rating Transparency Act would delay the release of the hospital star ratings until no earlier than July 31, 2017 and require CMS to accept comments for 60 days on its methodology and the data used. In addition, it asks that the methodology and data be validated by a third party.

The bill also would require the agency to remove the star ratings from the Hospital Compare website if they are posted prior to the bill’s enactment.

“Patients need clear, meaningful information to make important health care decisions,” said AHA Executive Vice President Tom Nickels in support of the legislation. “We continue to urge CMS to work with hospitals and health systems to provide patients with a rating system that accurately reflects the quality of care provided at their facilities, and will work with Reps. Renacci and Rice to move this legislation forward.”

On July 22, CMS released data on the national distribution of overall hospital quality star ratings and by hospital characteristics, including bed size, teaching status, safety-net status, eligibility for Disproportionate Share Hospital payments and critical access hospital status.

Earlier this month, the AHA, Association of American Medical Colleges, America’s Essential Hospitals, and Federation of American Hospitals urged CMS to share additional information with hospitals and the public about how accurately its overall hospital quality star ratings portray hospital performance, and to work with hospitals to validate the methodology or continue to withhold publication of the ratings.

A bipartisan group of House and Senate lawmakers have weighed in with the agency as well. In recent letters to CMS,  225 representatives and 60 senators urged CMS to delay the release of the ratings “to provide the necessary time to more closely examine the star rating methodology, analyze its impact on different types of hospitals, and provide more transparent information regarding the calculation of the ratings to determine accuracy.”

A recent analysis by an expert in econometrics found several shortcomings in CMS’s approach to the ratings.

“The data continues to raise questions and concerns, as it may unfairly penalize teaching hospitals and those serving the poor,” said Ashley Thompson, the AHA’s senior vice president for public policy analysis and development.

 

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