The American Hospital Association wants to do away with a key Medicare website feature that rates a hospital on patient satisfaction using 1 to 5 stars.
Each year hospitals that bill Medicare must complete a Hospital Consumer Assessment of Healthcare Providers and Systems Survey, also known as Hospital CAHPS, a survey designed as a standardized methodology for measuring patients’ perspectives on hospital care. The goal is for each hospital to get at least 300 completed patient surveys per year, says the Centers for Medicare and Medicaid Services.
The ratings are relatively new. The first star rankings appeared on Medicare.gov in July 2016 and were updated in October. The star ratings are based on self-reported data points from each hospital encompassing 64 quality measurements from seven categories that include mortality, safety of care, readmissions, patient experience, and effectiveness of care, timeliness of care and efficient use of medical imaging.
The Center for Medicare and Medicaid Services then uses an algorithm to assign a 1-5 star rating on about 3,700 hospitals nationwide, which consumers can view on the Hospital Compare section of Medicare.gov. But in a new letter to Center for Medicare and Medicaid Services administrator Seema Verma, the American Hospital Association is calling for an end to the star rankings.
The trade group, which represents about 5,000 hospitals and health systems nationwide, says the Center for Medicare and Medicaid Services ratings are based on faulty data. “CMS published a set of deeply flawed hospital star ratings on its website in fall 2016,” writes American Hospital Association executive vice president of government relations Thomas Nickels. “The ratings were broadly criticized by quality experts and Congress as being inaccurate and misleading to consumers seeking to know which hospitals were more likely to provide safer, higher quality care.”
Specifically, the association contends the ratings scheme unfairly penalizes teaching hospitals and those serving higher numbers of the poor, and largely focuses on important but relatively narrow aspects of hospital services like care for heart attack, stroke or pneumonia. The American Hospital Association, which has been a vocal critic of the star ratings since the development stage, is asking the Trump administration to get rid of them.
“While we continue to be concerned that CMS’s methodology is flawed, our concern is amplified by the fact that further analysis performed since the star ratings were first released show that substantive errors were made in executing CMS’s chosen methodology,” Nickels says. “As a result, far too many hospitals have been incorrectly classified into star rating categories that are different than those that should have been assigned.”
In general hospitals receive only mediocre ratings on Medicare Hospital Compare. In the initial ratings only 102 hospitals received a 5-star rating compared with three stars for about 1,800 hospitals and about 700 hospitals with two stars. The Center for Medicare and Medicaid Services has yet to react to the letter from the American Hospital Association.
But patient engagement and hospital patient satisfaction executives says the current five-star ratings do serve a purpose. “Consumers can look at measurements about patient experience and have an inherent trust because it is a government site,” says Andrew Rainey, executive vice president, strategy and corporate development at Binary Fountain, a provider of healthcare reputation management and patient experience analytics products and services.
The star rankings give consumers and patients “lots of relevant data to compare” hospitals but don’t provide the kind of consumer comments available on other comparison sites, such as Yelp, he says. “Patients want to read the individual comments and testimonials,” he says.