The Centers for Medicare and Medicaid Services (CMS) has postponed publication of its hospital ratings after numerous members of Congress objected to the rating system’s possible unfairness.
The publication is now expected to be published in July 2016.
“Many prominent hospitals that are in the top echelon of other quality rating reports, and handle the most complex procedures and patients, will receive one or two stars (out of possible five), indicating that they have the poorest quality in comparison to other hospitals,” lawmakers wrote to CMS Acting Administrator Andy Slavitt in an April 18 letter signed by 225 members of Congress.
The lawmakers’ specific concerns included CMS’ insufficient disclosure of its methodology and the possibility the rating system gives excessive weight to the “patient experience of care” category, as reported by patients, which accounts for 25 percent of a hospital’s score, according to CMS’s Quality Net website. The remaining criteria categories are outcome (40 percent), efficiency (25 percent), and clinical process of care (10 percent).
The American Hospital Association wrote to hospitals in a January 27 Quality Advisory report that of the 3,600 hospitals rated, 87 (2.4 percent) are expected to receive five stars and 858 (23.5 percent) to receive one or two stars.
Grace-Marie Turner, president of the Galen Institute, a nonprofit health and tax policy research organization, says the CMS ratings will force hospitals to divert attention from patients to bureaucrats.
“These rating systems are needed, but when the government becomes such a micromanager of the health care system, providers and hospitals become much more responsive to bureaucrats than to patients,” Turner said. “Hospitals will have no choice but to try to jump through hoops to meet CMS criteria—sometimes to the detriment of patients.”
Devon Herrick, a senior fellow at the National Center for Policy Analysis, says the five-star rating system gives patients insufficient and potentially misleading information about the value a hospital offers.
“The idea of one indicator, stars one to five, does not tell me where the hospital excels,” Herrick said. “Whether a hospital is one star or five does not necessarily mean the five-star [hospital] is a good value and the one-star [hospital] is poor. It may be some hospitals are concentrating on only those metrics that are measured by CMS.”
Michael McGrady ([email protected]) writes from Colorado Springs, Colorado.
Members of Congress Letter to CMS Requesting Delay of 2016 Five-Star Hospital Ratings, April 18, 2016: https://www.heartland.org/policy-documents/members-congress-letter-cms-requesting-delay-2016-five-star-hospital-ratings