Hospitals Come Up Short in New CMS Rating System

For the first time, the Centers for Medicare and Medicaid Services has instituted star ratings on Hospital Compare, the agency’s public information website, to make it easier for consumers to choose a hospital and assess the quality of care.

However, just 251 U.S. hospitals received the highest score on the new CMS five-star rating system for quality of care and patient experience.

Hospital Compare joins CMS’s other healthcare transparency websites—Dialysis Facility Compare, Nursing Home Compare, and Physician Compare—in adding the use of star ratings, which will be updated on a quarterly basis. Using a one-to-five-star scale, the rating system—based on results from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey of inpatients—scores hospitals on patient experience factors such as responsiveness of hospital staff, quality of care transitions, and how well medication information is communicated.

Also See: CMS Adds Star Ratings to Dialysis Facility Compare Website

The Hospital Compare website now features 12 HCAHPS star ratings, one for each of the 11 publicly reported HCAHPS measures, plus a summary star rating that combines or rolls up all the HCAHPS Star Ratings. But, critics charge that with 3,302 hospitals not receiving the highest rating, patients’ experience of care at the vast majority of Medicare-certified acute care hospitals is nowhere near where it needs to be.

Eric Heil, CEO of RightCare, a health IT vendor focused on providing seamless care transitions and reducing readmissions to improve quality of care, argues that the latest star ratings on the Hospital Compare website demonstrate how far hospitals have yet to go in improving patient experiences. The latest ratings based on patients discharged between July 1, 2013 and June 30, 2014 “highlights the areas that we can definitely improve upon,” said Heil, emphasizing that poor hospital scores “show the side effects of very inefficient processes including inter-hospital transitions but also across care settings.”

He believes that if hospitals “exude a culture of communication and collaboration amongst physicians, nurses, and house staff, it is the patient that ends up benefitting.” Yet, Heil says the opposite is true, with care for patients suffering in terms of readmissions and length of stay “which impact patient experiences in quality surveys.”

CMS adopted the star ratings after the Government Accountability Office took the agency’s Compare websites to task for their lack of relevant information on cost as well as providing limited information on key differences in quality of care, which GAO concluded was hindering the ability of consumers to make meaningful distinctions among providers based on their performance. Later this year, CMS plans to add star ratings for Home Health Compare—the last of the agency’s transparency websites to do so.

“This is critically important for what CMS is pushing, a value-based purchasing system. And, you have to have measurements to improve it,” concludes Heil. “You can’t improve what you can’t measure.”