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This inconsistent value matrix leads to a wide performance divide among five-star hospitals. Are all the shining stars here an accurate representation of quality? Of those, 20 performed at only the national average on patient safety. Based on the July 2016 release of hospital compare data, 40 percent of the 102 hospitals that received a five-star rating did not have the minimum data necessary to report on either mortality or readmissions. The fewer the clinical outcome domains a hospital reports, the less that hospital’s overall star rating is actually tied to performance on patient outcomes. Critics of the system also point to anomalous results such as the consistently low ratings of academic medical centers, which are generally considered among the nation’s best hospitals and which are often located in low income urban areas.Īs reported in Health Affairs, CMS calculated and published star ratings for hospitals that had sufficient data to report on as few as three quality domains, including some hospitals that only had data from one clinical outcome domain. The research by Bloomberg BNA compares star ratings of hospitals, indicating a correlation between high star ratings and high household income, and a corresponding correlation between low ratings and low income.Ĭritics of the rating system point out that low-income patients are more likely to have difficulty accessing transportation for both routine primary care and post-discharge follow-up care. That can and does affect readmission rates, which are a key component of quality ratings. Many of the hospitals widely considered to be the nation’s best were unable to achieve a five-star rating.Īccording to a recent analysis, this star rating system rewards hospitals that serve mostly affluent patients and punishes those serving the poor.
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The overall star ratings are based on 64 quality measures grouped under three process categories-effectiveness of care, efficient use of medical imaging, and timeliness of care-and four outcomes categories: mortality, patient experience, readmissions, and safety of care. As we reported, in July CMS released its first-ever hospital quality star ratings on its Hospital Compare website.