- 16% of Orgs Get Top-Marks in CMS Hospital Star Ratings for July 2023
- Are the Updated CMS Hospital Star Ratings Reliable Measures?
For example, a patient getting treated for a heart attack at a five-star hospital has a 50 percent lower risk of dying in the hospital than if treated at a one-star facility. Similarly, patients undergoing a total knee replacement at a five-star hospital have an 80 percent lower risk of complications than if treated in a one-star hospital.
Understanding hospital quality is an essential part of the patient care access process. Studies have shown that hospital quality is a leading influential factor in patient care access choices, followed by factors like cost and convenience.
Healthgrades said its hospital ratings are designed to help healthcare consumers understand hospital quality across organizations by leveraging a five-star rating scale with which most consumers are familiar in other industries. This approach reflects other healthcare industry rankings like the CMS Hospital Star Ratings or the letter grades handed out by The Leapfrog Group.
This year's Healthgrades 2024 Specialty Excellence Awards and Five-Star Specialty Care Ratings look at 16 specialty care areas, such as surgery, critical care, and orthopedic surgery, at around 4,500 hospitals. The Specialty Excellence Award goes to hospitals in the top 5 or 10 percent of hospitals for the different specialty care areas. Healthgrades also honored the top 100 and top 50 best hospitals for specialty care.
As noted above, Healthgrades is one of a handful of organizations that rate hospitals to help healthcare consumers make care access decisions. The Centers for Medicare and Medicaid Services (CMS) issues its own star ratings intended to help healthcare consumers make informed decisions about healthcare access, particularly for services that can be scheduled, like joint replacement and other elective surgery.
In a July 2023 update of the CMS Hospital Star Ratings, the agency reported that 16 percent of the 3,076 analyzed healthcare organizations got the top marks. Around 26 percent of hospitals got a 4-star rating, while about 28 percent got a 3-star rating, and just under 22 percent got a 2-star rating. A nominal 8 percent of hospitals received a 1-star rating, the agency said.
Around a third of hospitals submitting measures to CMS did not receive a star rating because they did not submit enough measures or report for enough categories to meet the criteria, the agency noted.
How Accurate Are Hospital Rating Systems?
Communicating healthcare quality to consumers can be challenging. Assessing healthcare quality is a complex process and usually encompasses many factors, ranging from clinical outcomes to risk adjustment. But outlining these caveats in a manner that is quickly and easily understandable does not always translate, some researchers have contended.
More specifically, some data has indicated that distilling hospital quality into a single five-star rating does not capture the nuances of hospital quality. In 2022, for example, a KNG Health analysis commissioned by the American Hospital Association showed that the CMS Hospital Star Rating methodology falls short for small, rural, and critical access hospitals.
That is because these smaller and usually under-resourced hospitals cannot report enough quality data to generate a reliable five-star rating.
A separate 2019 report in the New England Journal of Medicine Catalyst assessed four different hospital ratings systems, including the CMS and Healthgrades systems, on the likelihood of misclassifying hospital performance, the importance of impact with patient populations, the scientific acceptability of the rating system, history of iterative improvement, transparency, and system usability.
Overall, the researchers did not rate the ranking systems very high. Some of the analyzed rating systems issued states stating that the NEJM Catalyst did not accurately portray their methodologies in their analysis. It should also be stated that in the four years since the assessment, ranking systems may have updated their survey methodologies to better reflect hospital quality.
By Sara Heath