CMS overall star ratings have 'several shortcomings,' analysis finds

CMS' Overall Hospital Quality Star Ratings were supposed to be released in April, but the agency delayed the launch until July after many stakeholders expressed concern with the program. Now, a new analysis of the program conducted by a Georgetown University economist found the program's methodology has "several shortcomings."

Francis Vella, PhD, in Georgetown's Department of Economics in Washington, D.C., came out against the star ratings after conducting an analysis of the program's methodology.

Here are three of the methodology's main shortcomings, according to Dr. Vella's analysis:

1. The overall star ratings attempt to take a complex, multidimensional problem and put it into a simple measure, but Dr. Vella wrote he does "not see the net benefit" of doing so.

2. The methodology focuses solely on quality outcomes while ignoring their social determinants. "I feel ignoring other determinants of quality outcomes (such as location of hospital and patient composition) potentially biases the results," he wrote.

3. Finally, a star-based system can give a sense that a three-star hospital is substantially different from a four-star hospital, for instance, even when they are not that different. "Ranking the hospitals by stars is somewhat misleading as it indicates a qualitative jump as one goes from one category to the other and this may be inconsistent with reality and only reflects the scoring algorithm," Dr. Vella wrote.

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Dr. Valla isn't the only person or group to voice opposition to the overall star ratings program. Members from both the House and the Senate sent letters to CMS Acting Administrator Andy Slavitt earlier this year imploring him to delay the ratings, and many hospital advocacy groups did the same in March.

Consumer groups like AARP, on the other hand, have expressed support for the overall star ratings, saying patients need this information to help make smart healthcare decisions for themselves.

However, Rick Pollack, president and CEO of the American Hospital Association, asserts the ratings would be a hindrance to patients if released as-is.

"As currently designed, CMS' star hospital ratings program is not up to the task of providing the public with meaningful and accurate assessments of hospital performance," he said. "Patients need reliable information to make important choices regarding their healthcare. And hospitals and health systems need reliable information so that they can continue to improve the quality of the care delivered. CMS star ratings misses the mark on both accounts."

More articles on star ratings:
Home health gets the star treatment with quality rating updates
Overall star ratings from CMS still drawing ire, admiration after delay
Number of 5-star hospitals up slightly in new Hospital Compare update

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