Providing consumers with clear, accurate, useful information to aid in making critical health care decisions is a goal we all share. The Center for Medicare and Medicaid Services (CMS) star ratings system was intended to provide that help to consumers, their families and caregivers as they consider which hospitals will best serve them. At the same time, hospitals and health systems, outside experts and more than half of the members of the U.S. Senate and House have raised important questions about the accuracy of CMS’ methodology.
In a letter today to Patrick Conway, CMS’s deputy administrator for innovation and quality, a number of national hospital associations, including the AHA, voiced concerns over the proposed star ratings system.
CMS continues to decline to work with hospitals to examine and improve on the star ratings methodology. In the letter, we, along with the other associations, urge CMS to share additional information with hospitals and the public about how accurately star ratings portray hospital performance.
Until CMS has taken the time to address underlying methodological problems and share information with hospitals and the public demonstrating that its star ratings methods offer a fair and accurate assessment of hospital quality, we strongly urge the agency to continue to withhold publication of the flawed system.
In addition, we recently released a technical analysis of the star rating methodology by Dr. Francis Vella, chair of the Department of Economics at Georgetown University. Dr. Vella is a highly-regarded expert in econometrics and has extensive knowledge of the statistical modeling approach CMS used to create overall star ratings.
Dr. Vella’s analysis found that the star rating methodology could provide biased data because not all hospitals are judged using the same measures or even the same number of measures. He also called into question the choice of measures; weighting scheme; the apparent ignoring of social determinants such as hospital location or patient race or income; and the implication that substantial differences may exist among hospitals when, in reality, they do not.
Hospitals and health systems have a long history of providing transparent information on quality and patient safety efforts and will continue this tradition. That is why we want to work with CMS to provide information that is truly useful to patients, their families and the health care community.