AHA Statement on Star Ratings Update

Ashley Thompson
Senior Vice President, Public Policy Analysis and Development
American Hospital Association
April 28, 2021 


America’s hospitals and health systems have long supported transparency on quality because patients and their families need clear, useful information to make health care decisions. 

Today’s star ratings update is an improvement that will likely make the ratings more useful for both patients and hospitals. For example, we are pleased that CMS is now calculating hospital performance by simple averages, rather than using a previously flawed approach. In addition, we appreciate that CMS reorganized some of the measures so individual topics wouldn’t carry an undue amount of weight in the determination of star ratings. These changes have made the star ratings easier to interpret, more insightful for hospitals working to improve their quality of care, and more balanced in favor of high-priority topics, like infections. 

However, certain changes might not have the effect that CMS hopes, and there remain flaws in the methodology that CMS must address. We remain concerned that CMS’s failure to account for social risk factors in calculating performance on measures like readmissions biases the ratings against those hospitals caring for more vulnerable patients. Further, while we agree with the intent of CMS’s new peer grouping approach – that is, to create a more level playing field between hospitals offering differing levels of care – we believe it needs improvement to ensure it fosters equitable comparisons. Finally, and importantly, because the star ratings methodology has changed so frequently and significantly since its inception, comparing a hospital’s latest overall star rating with a previous rating could be very misleading.  

The AHA remains committed to working with CMS on our shared goal: providing patients with accurate, purposeful information about quality.