CMS star ratings: Hospital frustration, concerns over methodology

CMS

In the wake of a new report that calls into question the methodology used to determine star ratings for individual hospitals, national trade groups continue to express dissatisfaction with the Centers for Medicare & Medicaid Services’ quality rating system as well as their level of involvement in the process.

CMS was supposed to release the rankings in April but delayed it after industry leaders and lawmakers complained that the data didn’t take into account hospitals that treat patients with low socioeconomic status or multiple complex chronic conditions. Although the agency said it would delay the release until July, it hasn't yet announced the new release date

But the new report from Georgetown University noted the CMS methodology has several shortcomings and only incorporated quality outcomes rather than characteristic of patients or hospitals.

“I cannot see how one can ignore the implications of these factors on such measures such as mortality etc.,” Francis Vella of Georgetown’s Department of Economics writes. “Two (or more) identical hospitals could have very different outcomes depending on the type of patient they have, where they are located, the type of health issues they typically face and multiple other factors.”

Numerous groups, including the American Hospital Assocaition, the Federation of American Hospitals, the Association of American Medical Colleges and America’s Essential Hospitals, also registered disappointment in what they called CMS’ failure to keep them in the loop on the agency’s methodology for its star ratings.

“In addition, our continued review of the limited information available to us raises serious questions about the ability of the proposed ratings approach to provide accurate and meaningful information to patients,” the groups wrote in a letter to CMS Deputy Administrator for Innovation and Quality Patrick Conway, M.D.

CMS, they write, must provide hospitals and the general public with a wider range of information about the rating process as well as make several corrections to the methodology, including a potential adjustment to account for sociodemographic data.

- read the letter
- here’s the report (.pdf)

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