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Medicare Officials Reveal Star Rating System for Hospitals

By Rebecca Adams, CQ Roll Call

April 16, 2015 -- Consumers intent on comparing the quality of hospitals now have more data. The Centers for Medicare and Medicaid Services (CMS) has released the first-ever star ratings for more than 3,500 U.S. health facilities.

The ratings are on a scale of one to five, with five being the highest possible rating. Of the hospitals surveyed, 1,414 received a summary rating of three stars. Another 1,205 achieved four-state status. Only 251 got the highest grade.

A total of 582 hospitals got two stars while 101 received one star. Some 1,102 hospitals were not scored because there was not enough data.

The ratings system joins similar rankings for nursing homes, physicians' groups, dialysis facilities and Medicare Advantage plans. CMS officials plan to release star ratings for home health later this year.

An average consumer may have a hard time comparing star ratings for a large number of hospitals at a time. People using the agency's Hospital Compare tool can only look at side-by-side information for a few facilities at once. More detailed information is online in data sets, but it may be difficult for the uninitiated to digest.

Hospitals raised some questions about the release of the data, which had been in the works for years. Administrators also want the public to understand that the ratings are based on patient surveys. The Hospital Compare tool also has information about other quality measures, such as whether patients received the right type of care for conditions such as a heart attack or pneumonia and how many patients were readmitted after being discharged. 

"While star ratings could be an effective way to make quality information easier to understand, the devil is in the details," said Akin Demehin, American Hospital Association senior associate director of policy. "There's a risk of oversimplifying the complexity of quality care or misinterpreting what is important to a particular patient, especially since patients seek care for many different reasons. Hospital rating systems also need to keep up with the rapidly evolving nature of the quality measures underlying them."

The ratings are based on a survey that has been used since 2006 to measure patients' perspectives of hospital care.

The new ratings are based on responses from patients who were hospitalized between July 2013 and June 2014. The summary score is based on 11 different measures. Patients rated hospitals on questions such as how well nurses and doctors communicated with patients, whether the hospital was quiet at night, how quickly medical professionals responded to patients, how well patients' pain was managed, how clean the facility was, and whether patients understood what to do to take care of themselves after leaving the hospital.

CMS and Yale University also are creating a methodology for an overall hospital star rating that will include all of the quality measures reported on Hospital Compare. That overall hospital rating is planned to be available starting next year.

The information about patients' experiences is part of a broader effort by the federal government to pressure providers such as hospitals to provide higher-quality care and reward those that achieve goals on quality.

Patrick Conway, Acting Principal Deputy Administrator for CMS, said that the star ratings "encourage hospitals and clinicians to strive to continuously improve the patient experience and quality of care delivered to all patients."

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