CMS to delay star ratings update pending expert panel review

By | July 14, 2019

Dive Brief:

  • CMS will hold off on updating the controversial hospital star ratings pending a review from an expert panel, an agency spokesperson confirmed to Healthcare Dive on Friday.
  • CMS is convening a technical panel composed of industry experts to look at the methodology it uses to calculate the ratings and recommend improvements to the overall system. The review, first reported by Modern Healthcare, will incorporate stakeholder feedback on the star ratings received this spring.
  • The agency received more than 800 comments on the star ratings system and plans to make that feedback publicly available later this summer, the spokesperson said. Hospitals should expect more detail on the panel and its findings at about the same time.

Dive Insight:

The Overall Hospital Quality Star Ratings on Hospital Compare has been deeply unpopular with providers since its introduction in 2005. A lot rides on quality ratings and online reviews for hospitals in an age where consumers increasingly turn to the internet for recommendations on where to receive medical services.

A low ranking on Hospital Compare, which reviews more than 4,000 Medicare-certified, Veteran’s Health Administration and military hospitals, can damage a provider’s brand, reputation and bottom line. Perennial critics such as the American Hospital Association and America’s Essential Hospitals say the program heaps more regulatory burden on already stressed facilities, unfairly dings safety net hospitals, doesn’t help patients and is misleading by overly simplifying quality of medical care, a notoriously tricky metric to pin down.

In an attempt to workshop the program, CMS floated potential changes to the methodology for calculating the star ratings in February (which is also when it last updated hospitals’ scores in the system after delays lasting more than a year).

The 48-page request for public comment proposed a slate of potential options to modernize the quality ratings system meant to improve precision and allow for more direct facility-by-facility comparison. Possible changes include placing like hospitals into peer groups instead of weighing them against the entire pool of facilities, changing how CMS groups and weighs measures, shifting the timeline of reporting the ratings and tweaking the computational model (called the latent variable model) to make it faster and more precise.

Typically, the ratings are updated roughly once every six months, which would pin the next refresh sometime around August. But CMS plans to delay updating the rankings until the expert panel completes its review and issues suggestions on improving the program.

Though the spokesperson declined to provide a more specific timeline, industry should expect to hear more later this summer.

“As CMS works with hospitals, consumers and other stakeholders to consider potential improvements to the Star Ratings, our priority remains ensuring Hospital Compare provides consumers with meaningful, easy-to-use information on hospital safety and quality that empowers them to make informed decisions about their care,” the spokesperson told Healthcare Dive.

“We realize the importance of this issue to hospitals,” the CMS spokesperson said.

AHA, which in the past has slammed the program as “flawed from the outset” and lobbied for its complete termination, was supportive Friday that CMS is putting an expert microscope on the program.

“The AHA appreciates that CMS, as we have urged, is seeking further expert input on its star ratings methodology,” Ashley Thompson, the group’s senior vice president of policy, said in a statement. “We continue to believe that the agency must improve the accuracy and meaningfulness of star ratings before they are republished.”

CMS collects the quality data from its Hospital Quality Initiative programs, and the public can view the star ratings on the Hospital Compare website.

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