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CMS Star Rating System

CMS recently published a data showing how their yet to release Star Rating system will rate a hospital based on properties such as status and size. The agency is planning to post overall hospital star ratings soon on their Hospital Compare website. “We hope that by releasing our analysis of the impact of the overall star rating on different types of hospitals, we are able to clarify our ratings and address any questions or concerns about the data from stakeholders,” CMS said.

According to the released data, hospitals of all types, be it safety net institutions or teaching centers, would have varying quality according to the proposed Star Rating. Out of 4,599 hospitals, only 102 institutions received a five star rating; where 934 received four stars, 1770 received three stars, 722 got two stars, and 133 healthcare units received 1 star. The remaining 938 hospitals were denied of any rating, as they did not meet the threshold requirements of the Star Rating system.

Distribution stayed similar in few ways when limited by size, even if the hospital had more than 200 beds, 100-199 beds, or less than 100 beds. Only 2% hospitals got five star rating and 20% got four stars; whereas a quarter of the two categories among larger hospitals received a mere two stars in contrary with 5.6% of hospitals having fewer beds.

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There has been a significant difference in star rating by teaching status. Only 24.2% of non-teaching hospital was deemed non-applicable for star rating, when compared to 8.8 % of the teaching hospitals. The lowest mean rating was shown by safety net hospitals with 2.88 stars, as that compared to non-safety net hospitals, which scored an average 3.09 stars.

The same case could be seen with disproportionate share hospital payment eligible hospitals, which scored lower average of 2.92 stars, when compared to hospitals that are not eligible for DSH payment standing at an average of 3.47 stars.

CMS has published hospital star rating based on patient experience already. Overall hospital quality star rating is a composite scoring system with stars given in the order of 1 to 5, with 5 considered to be the best. The ratings are given with respect to the 62 quality measures ranging from hospital-acquired infection rates to complications followed by a hip replacement.

Nevertheless, the Star Rating system has got a lot of opposition from certain stakeholders. Hospital groups have asked CMS to delay the publishing of their star ratings, saying that the calculations were not accurate and would not reflect a hospitals’ actual quality. Reports say that CMS might hold the Star Rating system beyond July.

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