The American Hospital Association (AHA) is calling on CMS to immediately halt the use of star ratings on its Hospital Compare website, saying the ratings provide “an inaccurate, misleading picture of hospital quality.”
AHA’s Senior Vice President of Public Policy Analysis and Development, Ashley B. Thompson, sent a letter to CMS Chief Medical Officer Kate Goodrich, MD, asking her to suspend the “deeply flawed” ratings program. She also offered a long list of desired “regulatory relief.”
The ratings program poses a “regulatory burden” that is “substantial and unsustainable” for hospitals, Thompson said.
In addition to ending the ratings program, the AHA also asked CMS to cancel Stage 3 of the meaningful use program, suspend the electronic clinical quality measure reporting requirements, and use only “measures that matter” rather than the 90 hospital quality measures currently tracked.
The letter noted that 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.
“However, CMS’s flawed approach to star ratings undermines this goal by providing an inaccurate, misleading picture of hospital quality. That is why a majority of Congress urged CMS to delay the reporting of star ratings last year, and why the AHA and others have repeatedly urged CMS to suspend the reporting of overall star ratings until the methodology is improved,” Thompson wrote. The letter goes on to note that “CMS’s own analysis shows that nearly 700 hospitals would experience a change in their star ratings, amplifying our concern about the reliability and accuracy of the chosen methodology. At a minimum, the AHA strongly urges CMS to remove the star ratings from Hospital Compare and not republish them until it corrects the errors and outside experts agree that the updated methodology is executed correctly.”
The AHA has criticized the star ratings methodology before, and Thompson conceded in the letter that proposed updates from CMS correct some of those methodology errors. The updates, which were published in August 2017 under contract with the Yale New Haven Hospital System Center for Outcomes Research and Evaluation (YNHHS CORE), focus on measure selection and grouping, calculation of measure group scores using a latent variable model, and determination of overall star rating using k-means clustering.
The AHA addresses those proposed updates in the letter, but calls them insufficient to justify continuing the star ratings program. (The AHA letter is available online at: http://bit.ly/2xILh4F.)