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First Release of the Overall Hospital Quality Star Rating on Hospital Compare


Centers for Medicaid and Medicare Services (CMS.gov) 

July 27, 2016

Today, we are updating the star ratings on the Hospital Compare website to help millions of patients and their families learn about the quality of hospitals, compare facilities in their area side-by-side, and ask important questions about care quality when visiting a hospital or other health care provider. Today’s update comes after substantive discussions with hospitals and other stakeholders to review the Overall Hospital Quality Star Rating’s methodology. To learn more about our outreach and education with stakeholders and hospitals, please visit: http://blog.cms.gov/2016/07/27/helping-consumers-make-care-choices-through-hospital-compare.

Background

The Overall Hospital Quality Star Rating is designed to help individuals, their family members, and caregivers compare hospitals in an easily understandable way. Over the past decade, the Centers for Medicare & Medicaid Services (CMS) has published information about the quality of care across the five different health care settings that most families encounter.[1]

The new Overall Hospital Quality Star Rating summarizes data from existing quality measures publicly reported onHospital Compare into a single star rating for each hospital, making it easier for consumers to compare hospitals and interpret complex quality information. This overall rating supplements the star ratings currently posted for hospitals on their patient experience of care data (https://www.medicare.gov/HospitalCompare/Data/Patient-Experience-Domain.html), based on data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey. The patient experience of care hospital star ratings were first publicly reported in April 2015.

The methodology for the new Overall Hospital Quality Star Rating was developed with significant input form a Technical Expert Panel (TEP) and refined after public input. CMS will continue to analyze the star rating data and consider public feedback to make enhancements to the scoring methodology as needed. The star rating will be updated quarterly, and will incorporate new measures as they are publicly reported on the website as well as remove measures retired from the quality reporting programs.

We have received numerous letters from national patient and consumer advocacy groups supporting the release of these ratings because it improves the transparency and accessibility of hospital quality information. In addition, researchers found that hospitals with more stars on the Hospital Compare website have tended to have lower death and readmission rates.[2],[3]   

Measures Selected for Inclusion in Overall Rating

The new Overall Hospital Quality Star Rating will include 64 of the more than 100 measures displayed on Hospital Compare. CMS collects the information on these measures through the Hospital Inpatient Quality Reporting (IQR) Program and Hospital Outpatient Quality Reporting (OQR) Program.

Hospitals are only assessed on the measures for which they submit data. Some of the measures used to calculate the Overall Hospital Quality Star Rating are based only on data from Medicare beneficiaries and some are based on data from hospitals’ general patient population, regardless of payer. For example, measures on deaths, readmissions, and use of medical imaging include data from Medicare beneficiaries only. The patient experience, safety, and timely and effective care measures include data from any adult patient treated at hospitals. Specialized and cutting edge care that certain hospitals provide, such as specialized cancer care, are not reflected in these quality ratings.

A complete list of measures included in this star rating is provided in the Overall Hospital Quality Star Rating Methodology Report available on QualityNet.

Methodology for Calculating the Star Rating

The methodology for the new Overall Hospital Quality Star Rating was developed with significant input from a Technical Expert Panel (TEP) and refined after public input. The TEP, which included nominated individuals with various expertise, met three times. The first meeting established the inclusion criteria for measures to be included in the star rating, and the second and third meetings established the methodology to calculate the star rating.

We also hosted two opportunities for public input and hosted two National Provider Calls with over 4,000 participants. Hospitals had an opportunity to review their Overall Hospital Quality Star Rating, ask questions, and provide feedback during a “dry run” in July and August 2015.

CMS designed the methodology to be inclusive of as many hospitals and as many measures as possible. This approach prevents the methodology from limiting star rating calculations to certain types of hospitals based on characteristic or size. CMS will continue to re-evaluate and make any needed modifications to the methodology over time. We will also continue to work closely with hospitals and other stakeholders to enhance the Overall Hospital Quality Star Rating based on feedback and experience.

Today, we are taking a step forward in our commitment to transparency by releasing the Overall Hospital Quality Star Rating. We have been posting star ratings for different for facilities for a decade and have found that publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries. These star rating programs are part of the Administration’s Open Data Initiative, which aims to make government data freely available and useful while ensuring privacy, confidentiality, and security. 

For more information on the methodology, please see the Overall Hospital Quality Star Rating Methodology Report available on QualityNet.

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1. CMS Compare websites include: Nursing Home ComparePhysician CompareMedicare Plan FinderDialysis Compare; and Home Health Compare.

2. Wang DE, Tsugawa Y, Figueroa JF, Jha AK. Association Between the Centers for Medicare and Medicaid Services Hospital Star Rating and Patient Outcomes. JAMA Intern Med. 2016;176(6):848-850. doi:10.1001/jamainternmed.2016.0784. http://archinte.jamanetwork.com/article.aspx?articleid=2513630

3. Trzeciak, S. Gaughan, J. Mazzarelli, A. Association Between Medicare Summary Star Ratings and Clinical Outcomes in US Hospitals. Journal of Patient Experience. 2016 vol. 3 no. 1 2374373516636681 doi: 10.1177/2374373516636681 http://jpx.sagepub.com/content/3/1/2374373516636681.abstract

 

 

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