Despite strenuous objections from the hospital industry, Medicare's Hospital Compare website now includes star ratings intended to give consumers a quick take on a facility's overall quality. The fight goes on. Legislation introduced in Congress days before their release last week includes a provision to rescind them, but the ratings are out there.
News outlets across the country reported how area hospitals performed, in most cases highlighting which did the worst. Some hospitals and systems, including San Diego-based Scripps Health, issued news releases promoting their five stars. Others, such as the three-star Northwestern Memorial Hospital in Chicago, are being asked to explain why their rating is lower than their reputation suggests it should be. As Kaiser Health News reported, San Diego's La Jolla neighborhood has more five-star hospitals than New York or Boston.
The industry's trade groups are continuing to press their case—they previously persuaded the CMS to delay the release—that the ratings are built on a flawed methodology and oversimplify a complex matter—the quality of multifaceted institutions.
The ratings are a composite metric of one to five stars, assigned to about 3,700 U.S. hospitals (more than 900 were excluded because they didn't meet certain reporting thresholds). They are based on as many as 64 measures, such as hospital-acquired infection rates or emergency room wait times. It grouped those measures into broader categories and then weighted them.
“I still have real concerns that this system could unfairly penalize teaching hospitals and hospitals that serve poor communities, and that patients will ultimately pay the price,” said Rep. Kathleen Rice (D-N.Y.), who co-sponsored the bill to shelve the ratings for a year.
The CMS said last week it may adjust the framework based on recommendations from HHS' office of the assistant secretary for planning and evaluation, which is studying the impact of socio-economic status on quality measures.