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CMS Proposes Updates to Hospital Compare, Star Ratings Methodology

CMS has updated the data housed on Hospital Compare, as well as revamped the Hospital Star Ratings formulary.

cms star ratings hospital compare

By Sara Heath

- CMS has proposed updates to the Hospital Star Ratings formulary, according to an agency statement. These changes come in response to public criticism stating that the Hospital Star Ratings are not always accurate portrayals of hospital quality.

The changes would allow for more precise hospital rankings, CMS said. Additionally, the updates would help patients make more “like-to-like” comparisons, meaning they could compare similar hospitals. The agency would accomplish this by placing hospitals into peer groups – meaning small rural hospitals would not be compared to larger, academic hospitals.

Those changes will help patients make more informed decisions about their care, CMS said. The proposal will be open for public comment until March 29, 2019.

These proposed updates come amidst sharp criticism from key industry leaders.

The American Hospital Association, for example, has long denounced the Hospital Star Ratings formulary, saying it is too simple and does not offer an accurate portrayal of hospital quality.

As recently as September 2017, AHA has called into question whether the data offered in the Hospital Star Ratings listings was ready for patients. This data does not represent the nuances of hospital quality. After all, the Star Ratings are a five-point distillation of nearly 60 care quality indicators.

“The AHA has long supported transparency and continues to share CMS’s goal of making the data on Hospital Compare easier for consumers to understand,” AHA said in a 2017 letter about Star Ratings updates. “However, CMS’s flawed approach to star ratings undermines this goal by providing an inaccurate, misleading picture of hospital quality.”

These most recent proposed updates aim to address the way patients compare hospitals by allowing patients to view hospitals that are similar in the same category. The proposal will not necessarily address the formulary issues AHA and other stakeholders have pointed out.

CMS has also added new data to its Hospital Compare website, the patient-facing tool aimed at helping healthcare consumers make informed decisions about care access.

The data includes quarterly assessments of hospital quality, as well as the Hospital Star Ratings, which were most recently updated in December 2017.

These updates aim to improve the patient experience with the Hospital Compare tool, specifically by ensuring patients have the most recent information available for treatment decisions, said CMS Administrator Seema Verma.

“The Hospital Compare website and Star Ratings System are valuable consumer tools that provide helpful and important information on the safety and quality of our nation’s hospitals,” Verma said in a statement. “These decision-making tools offer greater transparency on hospital performance for a wide variety of users – patients, caregivers, families, and the broader healthcare industry. We constantly aim to improve these resources with feedback from stakeholders, and we are confident this latest update of Hospital Compare data further strengthens this data.”

In addition to informing patient and family treatment decisions, CMS intends the Hospital Compare websites to inspire quality improvements. With care quality data publicly posted, the agency expects hospitals to continually work for improvement.

The Hospital Compare website currently offers patients access to quality data about nearly 4,000 Medicare hospitals, as well as about Veterans Health Administration and Military Health Services hospitals. The website allows patients to search by medical condition, as well as by patient experience score, timeliness and effectiveness of care, and complication rates.

This data disclosure is presented in an easy-to-understand format, taking into account various levels of health literacy, CMS says.

Currently, hospitals have 30 days to review their quality data before it is publicly posted to the Hospital Compare website.

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