Federal hospital quality ratings slated to be released in April were postponed until at least July after the hospital industry and Congress pressed for a delay.
The delay occurred one day before the Centers for Medicare and Medicaid Services (CMS) was scheduled to release its new data, which would boil down assorted measures of quality into a rating from one to five stars.
A letter signed by 225 members of the House of Representatives and 60 senators said hospitals claimed “that they do not have the necessary data to replicate or evaluate CMS’s work to ensure that the methodology is accurate or fair.”
In addition, a March letter signed by the Association of American Medical Colleges, the American Hospital Association, America’s Essential Hospitals and the Federation of American Hospitals expressed similar concerns.
“Many of the nation’s best-known hospitals, institutions that serve low-income and complex patients, and are highly rated in other quality rating reports, will be receiving 1 and 2 stars (out of 5 stars). This is due to the fact that the ratings rely heavily on measures … researchers have identified as being inappropriately risk adjusted. These ratings do not account for hospitals that serve highly complex patients with significant socioeconomic challenges and that also perform a greater number of complex surgeries.”
CMS agreed to the delay, saying it would work with the hospitals to refine and improve the ratings. It indicated the ratings release delay could extend past July.
As the ratings now stand, mortality, readmissions, patient experience and safety of care metrics each comprise 22% of the ratings. The remaining 12% measure effectiveness of care, timeliness of care and the efficient use of medical imaging.
Those standards drew criticism from Harvard School of Public Health researcher Dr. Ashish Jha.
“The idea that dying and being readmitted to the hospital are equally important to patients seems funny to me,” Jha told National Public Radio (NPR).
You Might Also Enjoy: Study: 50 Hospitals Charge Uninsured 10 Times Cost of Care
Previous measures
A year ago, CMS developed a star rating compiled from patient surveys based on 11 facets of patient experience, but only 251 hospitals – about 7% of all hospitals judged – received a five-star rating, according to an April 16, 2015 article by Kaiser Health News. When it assigned stars, Medicare compared hospitals against each other. There were 13 states and Washington, D.C. that had zero five-star hospitals.
Those ratings were criticized because top hospitals often received mediocre ratings, while lesser-known local hospitals – or those where lucrative surgeries occurred – received better grades.
Many of the organizations that called for the delay in this year’s ratings also had qualms with the 2015 version. For example, the American Hospital Association said the star system risked “oversimplifying the quality of patient care or misinterpreting what is important to a particular patient.”
While hospitals and healthcare organizations nit-pick over standards and semantics, there seems to be a growing public interest in ratings.
A paper published in April in the journal HealthAffairs noted that the increased use of technology enables consumers to access far more healthcare information than in the past and, in general, be better educated.
“The delay is a necessary step as hospitals and health systems work with CMS to improve the ratings for patients, and the American Hospital Association (AHA) commends CMS for their decision,” Rick Pollack, president of the AHA said in a statement.
