Hospital star ratings useful, but don't tell the whole story

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The Centers for Medicare & Medicaid Services' star-rating system has raised questions about its usefulness, prompting the agency to break down exactly how it arrives at the ratings. But a look at the data shows it's unclear how much the system actually helps consumers choose the best care, according to an article in JAMA.

Harvard's Ashish K. Jha, M.D., and colleagues analyzed data to determine whether the star ratings steer patients in the direction of safer hospitals. Their analysis determined that for every 70 patients transferred from a one-star facility to a five-star facility, one life would be saved. However, holding all other factors constant, star ratings became a much less reliable predictor of patient safety and mortality when comparing different types of hospitals, such as urban teaching hospitals and small rural providers.

While the stars can help determine which hospitals provide the best care, Jha wrote that there are other factors at play and the star rating shouldn't be the sole determinant of consumer choice. Part of the reason for this is that star ratings hinge heavily on information reported by patients, which means numerous factors beyond simple care quality will contribute to the difference in ratings between large urban facilities and smaller rural facilities.

The good news, Jha wrote, is that CMS is working to make the ratings more reflective of such factors, with the agency recently confirming it's exploring adding sociodemographic factors to the rating system. The next round of ratings has been postponed until July in the wake of complaints from legislators and industry groups that the data didn't include hospitals caring for low-income and high-risk patients.

To learn more:
- read the JAMA piece
- here's the study abstract

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