CMS rolls out five-star scale to rank hospitals on patient experience

In an attempt to simplify hospital quality ratings for consumers, the Centers for Medicare & Medicaid Services (CMS) has unveiled a new feature on its Hospital Compare website that ranks facilities on a five-star scale, CMS announced Thursday.

The star ratings will use data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which measures patient experience at the nearly 3,500 Medicare-certified acute care hospitals according to metrics such as facility cleanliness, staff responsiveness and clinician communication. CMS will assign a star rating to each of the 11 publicly reported HCAHPS measures as well as a summary rating for each hospital. The agency also said it plans to update the ratings each quarter.

Only 251 hospitals--or 7 percent of those ranked--received a five-star rating under the new system, Kaiser Health News reported. The largest share of hospitals (40 percent) received three stars, including highly respected institutions such as Cedars-Sinai Medical Center in Los Angeles, NewYork-Presbyterian Hospital in Manhattan and Northwestern Memorial Hospital in Chicago. Only 3 percent of hospitals netted one star. 

The American Hospital Association (AHA) has been critical of the plan to phase in star ratings, arguing that how CMS weights the rankings fails to account for "a range of socioeconomic factors" beyond hospitals' control and thus would unfairly penalize facilities that treat larger numbers of disadvantaged patients, FierceHealthFinance reported. Furthermore, "there's a risk of oversimplifying the complexity of quality care or misinterpreting what is important to a particular patient, especially since patients seek care for many different reasons," Akin Demehin, AHA's senior associate director of policy, wrote in an email to Hospitals & Health Networks Daily.  

But CMS Acting Principal Deputy Administrator Patrick Conway, M.D., said in the announcement that the star ratings will "make it easier for consumers to use the information on the Hospital Compare website and spotlight excellence in healthcare quality" as well as "encourage hospitals and clinicians to strive to continuously improve the patient experience and quality of care delivered to all patients." CMS also plans to eventually use the star ratings to rank hospitals on measures such as clinical outcomes and patient safety, Conway told KHN.

CMS already uses star ratings for other consumer-geared websites such as Nursing Home Compare, Physician Compare, Home Health Compare and Medicare Plan Finder, according to a fact sheet from the agency. Though Hospital Compare already features an "Overall Hospital Rating" measure, CMS states that "each measure is valid and useful to consumers." The agency also encourages consumers to discuss hospital quality with their healthcare professionals when selecting a facility for treatment.

To learn more:
- read the announcement
- check out the fact sheet
- read the KHN report
- here's the H&HN article