A large percentage of hospitals that received Medicare's top five-star rating on patient satisfaction were penalized for excessive readmissions or fared poorly on curbing hospital-acquired conditions, a Modern Healthcare analysis shows.
Of 151 five-star hospitals on which data were also available for three other CMS quality programs, 39% received a penalty for excessive 30-day readmissions. In addition, 47% received a score of 5 or higher for hospital-acquired conditions (HAC) on a 1-10 scale where 1 is the best. The remaining 100 five-star hospitals did not have fiscal 2015 data reported for the other CMS quality programs.
Most of the 151 hospitals did well on value-based purchasing, which rewards or penalizes facilities based on how they perform on a suite of quality measures, including patient satisfaction. But many experts say those measures do not necessarily reflect the outcomes patients care most about, including mortality and readmission rates.
The CMS posted the star ratings April 16 on its Hospital Compare website, based on a five-star scale with 5 being the highest score. The ratings reflect an average of hospitals' performance on 11 measures from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. That survey includes patient evaluations of the hospital staff's responsiveness, care transitions, how well information about medications is communicated, and cleanliness and quietness of the facility. The ratings are from patient responses gathered between July 1, 2013, and June 30, 2014.
The agency cautioned that patient experience captures only one aspect of hospital quality and that patients should consider multiple factors when choosing a hospital.
But some experts reacted skeptically to the CMS' star-rating effort. And a new report from the Institute of Medicine said many of the measures healthcare providers are required to report are redundant, fragmented and limited in value.