Ahead of the release of its much-anticipated star ratings for overall hospital quality, the CMS published data Thursday showing how those star ratings are distributed according to hospital characteristics, such as size and status.
The agency said it planned to post overall hospital star ratings "shortly" on its Hospital Compare website. "We hope that by releasing our analysis of the impact of the overall star rating on different types of hospitals, we are able to clarify our ratings and address any questions or concerns about the data from stakeholders."
The data show that hospitals of all kinds—teaching hospitals or safety net institutions, for instance—can vary in quality as indicated by star ratings, the CMS said.
Out of 4,599 hospitals, just 2.2%, or 102 institutions, received a five-star rating, while 20.3% received four stars, 38.5% received three, 15.7% earned two stars and 2.9% received a single star. For 20.4% of hospitals, the star rating was deemed not applicable, a status conferred on hospitals that did not meet minimum reporting thresholds.
The distribution remained similar in some ways when limited by size. Whether they had fewer than 100 beds, 100-199 beds or more than 200 beds, about 2% of hospitals received five stars and about 20% received four stars. However, about a quarter of the two categories of larger hospitals received 2 stars, compared with 5.6% of hospitals with fewer beds.
The major difference in star ratings by teaching status was that 24.2% of non-teaching hospitals were listed as non-applicable for overall star ratings, compared with 8.8% of teaching hospitals.
Safety net hospitals had a slightly lower mean rating—2.88 stars—than non-safety net hospitals, which earned 3.09 stars on average. Hospitals eligible for disproportionate share hospital payments also ranked slightly lower on average than hospitals that were not eligible for DSH payments, receiving 2.92 stars versus 3.47.
The CMS already publishes hospital star ratings based on patient experience. Its Overall Hospital Quality Star Rating, however, is a composite scoring system of one to five stars, with five being the best, based on 62 quality measures that range from complications following a hip replacement to hospital-acquired infection rates.
The star-rating system has drawn opposition from some stakeholders. In early July hospital groups called on the CMS to postpone publishing those ratings for a second time, saying that they were calculated in a way that would not accurately reflect a hospital's quality. The agency has indicated that it might delay the ratings' publication beyond July.