The CMS this month plans to add a new five-star quality rating to its Hospital Compare website. The new rating will be an average of the star ratings for each of the 11 publicly reported measures from the Hospital Consumer Assessment of Healthcare Providers and Systems survey.
The HCAHPS survey evaluates patients' experiences at hospitals.
The move is part of a broader initiative by the federal agency to add the star ratings across all of its consumer-facing Compare Web pages to assist consumers in evaluating the quality of healthcare facilities.
The CMS first applied star ratings in 2008 to nursing homes. Last year, the agency rolled out similar programs for home health providers, large group practices and dialysis facilities, amid controversy about the methodology and whether or not the rating will add clarity or spark confusion.
The American Hospital Association, though supportive of the push for transparency in healthcare, expressed similar concerns about the ratings anticipated for Hospital Compare this month.
“A single star rating has the potential to oversimplify the information about quality that might be most relevant to patients,” said Akin Demehin, AHA's senior associate director of policy.
He also pointed out that the CMS is developing another star-rating methodology that would apply to all the other measures on Hospital Compare, such as readmission rates, number of complications and spending per beneficiary.
“Frankly, if they arrive at a methodology that is a significant departure from what will be publicly displayed this month, it can actually lead to a great deal of confusion among providers and patients,” Demehin said.
Hospitals had the opportunity to preview their overall HCAHPS star ratings in a dry run of the program last fall. The first public reporting of the ratings in April will be based on patients discharged between July 1, 2013, and June 30, 2014.
HCAHPS surveys are provided to a random sampling of patients within two days after they have been discharged from a hospital and must be completed within 42 days. Every day, on average, more than 8,400 patients complete the survey, the CMS said in a provider call last October.
It asks patients about factors such as the responsiveness of hospital staff, quality of care transitions and how well information about medications is communicated. It also asks about the cleanliness and quietness of the facility and whether or not they would be willing to recommend it to others.
Efforts to boost transparency in healthcare quality data and provide information consumers can use to make more informed decision about care have been a national priority. Still, the rollout of CMS' five-star program on the Compare websites has been met with criticism.
The agency announced in February that it is making it more difficult for nursing homes to get high marks, following reports of instances where nursing homes with poor quality still received four and five stars.
Dialysis providers have been vocal in their criticism of the methodology used to generate star ratings for their facilities; the rating method allows only a certain percentages of dialysis facilities in each decile.
