Hospital Groups Praise CMS Decision Delaying Star Ratings Report

CMS said it will not update its overall hospital quality star ratings on Hospital Compare as it planned to in July, and will instead seek feedback on planned changes from an expert panel and other stakeholders. Two industry groups, the American Hospital Association (AHA) and America’s Essential Hospitals, both welcomed the move.

“CMS made the right call in postponing the July update of star ratings, and we appreciate the agency allowing more time for a fuller analysis of its methodology and measures and to hear from stakeholders, including hospitals and health systems, about concerns found in many preview reports,” said AHA executive vice president Tom Nickels.

“Reviews of July preview reports show large shifts in overall hospital star ratings from December 2017 to July 2018. These changes have created confusion and raised new questions about the reliability and validity of the methodology used to calculate these ratings,” Bruce Siegel, MD, MPH, president and chief executive officer of America’s Essential Hospitals, said in a statement.

Both organizations have expressed concern about the ratings, which are a composite of quality measures covering things like how often patients have to wait in the emergency department, infection rates, readmission rates after a heart attack, and whether patients receive too many imaging scans.

“CMS has decided to postpone the July star ratings update to give time for additional analysis of the impact of changes to some of the measures on the star ratings and to address stakeholder concerns,” CMS said. “When changes are made to the underlying measures it is vital to take the time needed to understand the impact of those changes and ensure we are giving consumers the most useful information.”

As part of this process, CMS said it will seek feedback from a multidisciplinary technical expert panel, a provider leadership workgroup, and a public comment period.

Hospitals have been concerned that patients with more acute health problems due to higher rates of chronic disease would lead to penalties for poor health outcomes, pulling resources away from hospitals that most need federal funds.

In a preview document, CMS said it would no longer include pain management in the calculation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Summary Star Rating and the Hospital Compare Overall Hospital Quality Star Rating.

There has been concern that the HCAHPS survey indirectly leads to overprescribing of opioids, helping to fuel substance use disorder and deaths, but a study published last year in JAMA found no correlation between pain measurement scores and postoperative opioid prescribing rates.