By Jill Drachenberg, Managing Editor, AHC Media
CMS has launched its new overall quality star ratings for Medicare hospitals, which is raising the ire of hospitals and medical associations that have pushed the agency to block, or at least revise, the rating system.
The star ratings use data from 64 quality measures reported to Hospital Compare, including:
- outpatients who received cardiac imaging stress tests before low-risk outpatient surgery;
- deaths among patients with serious treatable complications after surgery and surgical site infections from colon surgery;
- rate of complications for hip/knee replacement patients;
- rate of unplanned readmission after hip/knee surgery;
- percentage of patients receiving appropriate recommendation for follow-up screening colonoscopy;
- percentage of patients with history of polyps receiving follow-up colonoscopy in the appropriate timeframe;
- patients who received treatment to prevent blood clots on the day of or day after hospital admission or surgery. (See the quality measures at http://bit.ly/1OTT6ZB.)
Hospital officials have resisted the release of the ratings, and they have argued that treating high numbers of complicated cases, and CMS’ possible use of outdated statistics, could make some high-quality and prestigious medical centers look bad. “We are … disappointed that CMS moved forward with release of its star ratings, which clearly are not ready for prime time,” said American Hospital Association (AHA) President Rick Pollack in a statement. “As written, they fall short of meeting principles that the AHA has embraced for quality report cards and rating systems.”
A total of 129 hospitals scored only one star. (The full list of hospitals and their star ratings can be found at http://bit.ly/1OTT6ZB.)
The AHA and other industry organizations opposed the overall star ratings and expressed concerns that the information would not accurately represent hospitals in a meaningful way. Hospitals with high numbers of patients with complicated conditions, low income, or low health literacy may have higher rates of readmissions or adverse events that do not reflect on the hospital’s overall quality of care. Members of Congress also urged CMS to postpone the star ratings and reconsider how the ratings are determined.
“[W]e are especially troubled that the current ratings scheme unfairly penalizes teaching hospitals and those serving higher numbers of the poor,” Pollack said. Medicare ratings do not adjust for socioeconomic conditions.
The current ranking breaks down as follows:
- 102 hospitals (2.2%) received five stars;
- 934 hospitals (20.3%), received four stars;
- 1,770 hospitals (38.5%) received three stars;
- 723 hospitals (15.7%) received two stars;
- 133 hospitals (2.9%) received one star.
The remaining 937 healthcare facilities (20.4%) were not rated because they didn’t report enough data.