CMS shares proposed star ratings changes: 4 takeaways

CMS has outlined proposed changes to the Overall Hospital Quality Star Rating methodology, which would take place next year.

The agency shared the changes in its Outpatient Prospective Payment System proposed rule released Aug. 4. 

Four takeaways:

1. CMS sorts star rating quality measures into seven groups and uses a statistical modeling method called latent variable modeling to create a composite score for each group. The proposed methodology would scrap latent variable modeling and instead use a simple average of measure scores to calculate the group score.

2. CMS proposed combining three process measure groups — effectiveness of care, timeliness of care and efficient use of medical imaging — into a single measure group labeled "timely and effective care." This consolidation would result in five  measure groups instead of seven. The proposal aligns with the CMS Meaningful Measure Initiative, which aims to reduce the regulatory hurdles associated with quality reporting. Star ratings currently include 51 quality measures, down from 64 when they launched in 2016. 

3. To receive a star rating, hospitals must share data on at least three measures in at least three measure groups, one of which must be the mortality or safety of care outcome group. CMS said the proposed consolidation of measure groups would help 157 morel critical access hospitals meet this threshold to receive a ranking. At present, these facilities serve too few patients to report measures for each group. 

4. Hospital groups and industry leaders have long called for changes to the star ratings system, saying the methodology is flawed and produces misleading results. Hospital groups responded fairly positively to the proposed changes this week.

"In light of the substantial flaws with CMS's current approach to hospital star ratings, we appreciate that the agency is exploring ways of improving the methodology," Tom Nickels, executive vice president of the American Hospital Association, said in a statement. "We look forward to reviewing the proposed methodology changes in depth."

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