08.26.2019

CMS to Use Flawed Star System Until it Devises a New One

The much-maligned system of rating hospitals by one-to-five stars that CMS has used since 2016 will, unfortunately, remain as is throughout 2020. CMS said it is open to changing the rating system methodology – but not until 2021.
 
A wide variety of healthcare interests, including MHA, have repeatedly opposed the concept of rating complex hospitals with simple stars. The criticisms range from how a single “quality” rating from the stars do not give consumers information about how well a hospital may provide a specific service such as cancer or heart care, to the fact that hospitals have no way of predicting how their performance on the underlying measures will translate into the star rating. That is, the ratings have little value in assisting improvement efforts.
 
Earlier this year, as CMS sought comments on the star measures, MHA wrote, “The very notion of trying to quantify overall hospital quality into a single composite score is flawed in its design of simplifying very complex data into a ‘one size fits all’ rating that may not be truly representative of all cases. The data and performance rates for the inpatient and outpatient quality reporting measures should speak for themselves as individual measures.”
  
Even though CMS received many such comments, the agency announced last week that it will keep the rating system unchanged in 2020, update the scores hospitals receive early next year, and roll out a new, as-yet-unannounced methodology in 2021.
 
The American Hospital Association said it was thankful CMS was addressing the flawed methodology, but added that waiting a year to do so helps no one. “Republishing the flawed ratings in 2020 will not advance the goal of providing the public with accurate, purposeful information about quality,” AHA wrote.