A new federal tool aimed at helping patients determine the best hospital for their care is raising questions over whether it provides an accurate assessment of quality.
The CMS is developing a hospital quality star-rating system for the Hospital Compare website. The system will provide currently available data regarding hospital quality measurement to help inform healthcare decisions, according to the federal agency.
The new hospital star system will pull data from several sources, which is different than the current system that's based on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, according to the CMS.
America's Essential Hospitals, which represents 250 safety net hospitals around the country, said it's concerned about the proposed methodology for the new system released by the agency earlier this year.
“We are not confident that the measures currently available on Hospital Compare enable CMS to create a single, methodologically sound rating of all aspects of hospital quality,” the group said in a letter to CMS acting Administrator Andy Slavitt.
“Although the intent of CMS, in developing an overall star-ratings system, is to provide patients with a simplified assessment of how hospitals perform overall on quality, each patient's circumstances are different and the quality measures most relevant to their care will differ,” the group adds.
Also of concern is whether the system will take into account if a hospital serves more of a high-risk population. The trade group believes the CMS methodology should incorporate risk adjustment for socio-economic factors so results reflect differences in treatment across hospitals.
Race, homelessness, cultural and linguistic barriers, low literacy and other socio-economic factors can skew results on certain quality measures, such as those for readmissions.
“Without proper risk adjustment, an essential hospital, serving a disproportionate share of lower-income patients with confounding socio-demographic factors, might be rated lower for reasons outside its control,” the group says. “The failure to appropriately risk adjust outcome measures, which in turn are included in the calculations of overall star ratings, can bias results and mislead patients.”
The letter was sent on the final day of a monthlong hospital star ratings dry run to give hospitals an opportunity to review an example of their star rating. The information was confidential.
The CMS will assess the right time to publicly post hospital star ratings on the Hospital Compare site, according to a frequently asked question document about the new star system. It had previously aimed for a 2016 launch.
A CMS spokesman didn't immediately return a request for comment.