CMS’s Hospital Star Ratings Appear to be Misleading: Do Those Rated Represent the Best in the Nation?
The Centers for Medicare and Medicaid Services (CMS) developed a system in July for rating hospitals on quality, rating systems across the United States on a scale of one to five stars, with five stars being the highest rating on quality. The purpose for the rating system is to provide education on hospital quality and allow patients to compare facilities.
Although the star ratings are intended to educate and provide insight into quality, the ratings may seem slightly misleading. Reputable hospitals that were previously highly ranked did not appear on the list from the CMS of five star rated hospitals; most names on that list are not familiar.
The hospital star ratings are based on 64 quality measures that fall under seven quality domains, but the CMS gives more rating significance on three particular quality domains: mortality, readmission and patient safety. If a hospital doesn’t report on these three quality domains as much as the others, the less that hospital’s star ratings are actually tied to performance. According to a report, 40% of the 102 hospitals with a five star quality rating did not possess the minimum data to report on mortality or readmissions. From these, only 20% performed at the national average on patient safety.
Although teaching hospitals are able to report on a majority of the quality domains, they have narrower service areas and less diverse patient populations. To receive higher ratings, teaching hospitals have to meet a higher standard. Their ratings are more weighted on the outcomes of their services rather than on the care delivery.
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