News: AHA comments on potential changes to CMS star rating methodology
At the beginning of March 2019, CMS updated the hospital star ratings publicly for the first time since 2017, despite repeated concerns that the ratings present a distorted view of quality of care. Though they did update the ratings, CMS Administrator Seema Verma also asked for stakeholder feedback on several potential changes (see this article in CDI Strategies for more details).
Last week, the American Hospital Association (AHA) released a statement saying that only three of the suggested changes should be pursued further:
- Empirical criteria for measure groups
- Peer grouping star ratings among hospitals
- Using an explicit scoring approach
“The remaining proposals,” the AHA wrote, “either fail to address important shortcomings with star ratings, or simply do not have enough information for us to judge their impact.”
Further, the AHA urged CMS to
- Enlist the help of a small group of experts on latent variable models to ensure the calculations are laid out correctly
- Examine how to mitigate the effect of outliers in calculating readmission measures in ratings
- Develop an alternative approach to star ratings in which hospitals receive ratings on specific clinical conditions and topic areas
Finally, the AHA suggested that CMS remove the current star ratings (updated in March) from Hospital Compare while they work to improve the rating methodology.
“Unless and until the ratings methodology is improved, it will be difficult for hospitals and the public to have confidence that star rating portray hospital performance accurately,” the AHA wrote.
Editor’s note: To read the full letter from the AHA, click here. To read about the March update to the star ratings, click here. To learn more about CMS’ star ratings, click here.