What you need to know about the new CMS Overall Hospital Quality Star Rating

August 30, 2016 Jenn Lau

By now, you’ve probably heard of the new CMS Overall Hospital Quality Star Ratings on Hospital Compare. If you haven’t, it’s a new system that allows for patients to do a simple search of their region and compare the quality of the surrounding hospitals, nursing homes, home health agencies and other health care providers by comparing the number of stars depicted.

The idea is to provide a comprehensive, patient-friendly method of communicating otherwise complex information by displaying a range of one to five stars. Sounds great, right?

Many healthcare professionals don’t seem to think so. The new rating system has garnered lots of discussion across the map. For example, the Overall Hospital Quality Star Rating is based on 64 measures, but hospitals are only assessed based on the data that they submit. If it’s not submitted, it’s not included in the overall rating. Some of the assessments—including measures on death, readmissions, and medical imaging—are only derived from Medicare beneficiaries. This compromises the overall rating of hospitals that serve low-income patient populations, and does not account for the difference in patient demographics across the US healthcare landscape.

Rick Pollack, president and CEO of the AHA, expressed his disappointment in many of the short-comings garnered by the new rating system. He emphasized that the “current ratings scheme unfairly penalizes teaching hospitals and those serving higher numbers of the poor,” concluding that they do not meet the standards of AHA quality reports and rating systems.

While we’re all in support of a transparent platform that allows patients to easily access information on hospital quality, patients shouldn’t be making decisions on their healthcare based on incongruous data. 

Luckily, CMS will be working with hospitals and other stakeholders to improve and iterate upon the rating system based on feedback and learnings. This could definitely be a step toward cultivating a transparent healthcare system that puts more power in the patient’s hands.

As healthcare providers and people on the front-end of patient experience, what can be done while we wait? 

With Patient Experience measures comprising 11/64 of the Overall Hospital Quality Star Ratings (which happen to be based on HCAHPS survey topics), here are some tidbits that may help elevate the patient’s stay: 

  • Train staff on the importance of communication with patients, and keeping them informed
  • Try reiterating instructions and information both verbally and in written form
  • Set up a Patient and Family Advisory Council (PFAC) to gain feedback from the patient community and increase patient participation in healthcare
  • Perform intentional rounding to proactively solve issues before they become complaints
  • Prepare staff for dealing with angry patients

 

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