CMS updates overall hospital star ratings: 5 things to know

After a five-month delay, CMS updated its Overall Hospital Quality Star Ratings on its Hospital Compare website on Thursday.

Here are five things to know.

1. CMS' Hospital Compare website reports on quality measures for more than 4,000 hospitals from around the country. CMS overall star ratings assigned to hospitals are based on 57 quality measures across seven areas of performance: mortality (seven measures), safety of care (eight measures), readmission (nine measures), patient experience (11 measures), effectiveness of care (10 measures), timeliness of care (seven measures) and the efficient use of medical imaging (five measures).

2. The agency has delayed the release of the ratings since July in order to retool its methodology and collect feedback. While praised by consumer groups, the ratings have drawn sharp critique regarding the quality of its methodology from multiple stakeholder organizations, including the American Hospital Association.

3. CMS said the new ratings are the result of recommendations from a panel of technical experts and public feedback.

"We continue to refine the star ratings and look forward to an ongoing dialogue with hospitals and patients and their families on how we can provide beneficiaries useful information," said CMS Administrator Seema Verma.

4. Changes to the new ratings are summarized in a specifications report. The report details 67 measures excluded for a number of reasons, including overlap with already existing measures and measures with 100 or fewer hospitals reporting. These measures include emergency department volume, prescribing aspirin at discharge and catheter-associated urinary tract infection in the intensive care unit.

5. Changes in the specific methodology used to stratify the ratings include the removal of winsorization from the statistical breakdown. Winsorization is a process that limits extreme values from arising in statistical analysis. As a result, the new ratings have a higher number of 5-star and 1-star hospitals.

Here's a breakdown of how the new star ratings compare to those issued by CMS last December:

  • Five stars: 337 in December 2017 (83 in December 2016)
  • Four stars: 1,155 (946)
  • Three stars: 1,187 (1,794)
  • Two stars: 753 (694)
  • One star: 260 (112)

To learn more about the hospital compare overall ratings, click here.

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