The Centers for Medicare and Medicaid Services has been toying with the idea of providing a “star rating” for hospital quality for some time now. Apparently, that time has come.
The Obama administration recently stated that it will soon publish star ratings summing up the quality of care at over 3500 hospitals. Nearly half of the hospitals will be rated as average, according to government figures.
The rationale for the star ratings? CMS says that the ratings will be more useful to patients than the current plethora of individual metrics – of which there are more than 100. The individual metrics also encompass technical matters that may not be particularly important or comprehensible to the average consumer. The star system – awarding a hospital anywhere between one and five stars – will be based on 64 of the individual measures that are already publicly available on the government’s Hospital Compare website, including metrics like mortality rate, rates of readmission, and infection rates.
Using the current data, 102 hospitals would receive the top rating of five stars, 934 would receive a four star rating, 1770 would receive three stars, 723 would be awarded two stars, and 144 would get only one star. CMS is hoping the simplified approach will be similar to other healthcare rating websites like Nursing Home Compare.
It’s important to note that the mix of patients at a hospital is factored into the ratings – meaning hospitals with a high proportion of sicker patients are not supposed to rate lower than hospitals seeing less ill patients.
The results are somewhat of a mixed bag though. Interestingly, there seemed to be little difference between hospitals of different sizes. Critical access hospitals – mostly small, rural facilities – performed slightly better overall. 22% of safety net hospitals performed above average, which was roughly on par with the overall rate. Teaching hospitals also received lower scores on average.
Obviously, the hospital industry is concerned, fearing that the ratings may be misleading and too simple. After all, we’ve all looked at a TripAdvisor or Yelp rating and wondered if someone’s five-star rating is someone else’s four or three stars. The hospital industry also points to the fact that so many prestigious hospitals fared poorly as an indicator that the methods may be flawed.
Ultimately, the real question is whether the results will be meaningful to both hospitals and consumers. If the ratings do not spur any change on the part of hospitals to improve quality of care, then they may not ultimately be that helpful. And consumers may not want to or be able to change their habits. For example, an increasing number of insurance plans are placing certain hospitals out of network, therefore making patients unable to transfer their care elsewhere without accumulating dramatic costs. Furthermore, transferring care to another hospital may require traveling prohibitively large distances.