News: CMS updates hospital star ratings after delay, signals plans for a change

Hospital star ratings were updated publicly Thursday for the first time since 2017, despite long-running accusations that the government’s methodology presents a distorted picture of care quality.

CMS repeatedly delayed the release of the updated ratings, citing “stakeholder concerns.” Hospitals had complained that preliminary data for the July 2018 release showed inexplicably dramatic shifts in ratings that added to concerns over their reliability, HealthLeaders Media reported.

In announcing the update to the Hospital Compare and Medicare data websites Thursday, CMS Administrator Seema Verma both defended the star ratings and signaled that changes are in the works.

"These decision-making tools offer greater transparency on hospital performance for a wide variety of users—patients, caregivers, families, and the broader healthcare industry," Verma said. "We constantly aim to improve these resources with feedback from stakeholders, and we are confident this latest update of Hospital Compare data further strengthens this data."

The announcement included a list of potential changes to the hospital star ratings. These include:

• Measure Grouping: Including potentially a three-step approach to regrouping, which groups measures based on clinical criteria; uses statistical tests to determine if an important latent quality trait is represented by the measures in the group; and actively follows measure groupings for consistency in how much each measure influences the measure group score over time.
• Incorporating Measure Precision: Including a change in the way that each measure’s and hospital’s scores precision are weighted within the statistical model, for example, if a hospital only cares for 50 heart failure patients, but cares for thousands of pneumonia patients, the pneumonia measure would contribute more to that hospital’s group score.
• Period to Period Shifts: CMS is considering is a transition to reporting the Overall Hospital Quality Star Ratings once a year, rather than twice (as currently), so that changes in hospital ratings are more predictable based on changes in underlying measures.
• Peer Grouping: CMS is considering grouping rankings based on hospitals that “look like them,” for example, safety-net, teaching, or rural/Critical Access Hospitals could be grouped together.

Public comment period closes March 29, according to HealthLeaders Media. The changes being considered include a plan to compare hospitals to their similarly situated peers.

The updated ratings are available on the Hospital Compare website.

Editor’s note: This article originally appeared in HealthLeaders Media. To learn more about CMS star ratings, click here.