Quality & Safety
Updated: December 20, 2022
- After accounting for poor reviews, patients rated small acute-care hospitals best in adjusted Hospital Consumer Assessment of Healthcare Providers and Systems survey results. But the median score for all three hospital sizes (small, medium and large) dropped slightly from the same period in 2019. (The survey was not collected due to the pandemic)
- That pattern - small rated more highly than larger - repeated itself among other types of hospitals. Minor teaching hospitals scored better than major teaching hospitals, and small critical-access hospitals scored better than medium or large critical-access hospitals. But all saw a slight drop in ratings in 2021 compared to 2019.
- Readmission rates for fiscal 2023 saw fewer hospitals getting large penalties compared with fiscal 2022. This is the first year the Centers for Medicare & Medicaid Services is using pandemic-era data to inform payment adjustments under its Hospital Readmissions Reduction Program, and the resulting penalties are the lowest hospitals have seen in nearly a decade.
- For fiscal 2023, hospitals with the lowest percentage of people eligible for both Medicare and Medicaid coverage in peer group 1 received the highest percentage of penalties over 1% from CMS. Peer group 1 also had the highest percentage of hospitals with no penalties based on their performance in reducing excess readmissions.
CMS Peer Groupings
The Centers for Medicare and Medicaid Services reduces payments up to 3% based on a hospital's performance in reducing excess readmissions for specific program measures, such as Chronic obstructive pulmonary disease (COPD).
In order to account for the challenge of treating different levels of dual-eligible patients (patients eligible for both Medicare and Medicaid), CMS groups hospitals into five peer groups, with peer group 1 having the lowest percentage of dual eligibles and peer group 5 the highest percentage.
Hospital performance is then assessed based on comparison to their peer group.
Penalty level for hospitals, by CMS peer group
Acute Care and Critical Access Hospitals
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