While the roughly one dozen potential changes to the hospital overall star ratings methodology outlined in a Centers for Medicare & Medicaid Services request for feedback merit serious consideration, the AHA believes that only three of the proposals should be pursued further at this time – empirical criteria for measure groups, peer grouping star ratings among similar hospitals, and using an “explicit” scoring approach.
“The remaining proposals either fail to address important shortcomings with star ratings, or simply do not have enough information for us to judge their impact,” AHA told the agency today in comments on the proposed changes.
AHA also urged CMS to engage a small group of experts on latent variable models to ensure its calculation approach is executed correctly; examine how to mitigate the impact of outliers in calculating readmissions measures in the ratings; and develop an alternative approach to star ratings in which, instead of an overall rating, hospitals receive ratings on specific clinical conditions or topic areas.
In addition, AHA urged CMS “to remove the existing star ratings from Hospital Compare while its important work of improving the methodology continues.”
CMS last month updated its hospital overall quality star ratings at Hospital Compare and proposed future changes to the star ratings methodology in response to stakeholder feedback.

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