CMS Mulls Adding Star Ratings to Hospital Compare Website

CMS is considering adopting a visual display -- such as star ratings -- to help consumers understand quality-of-care information posted on its Hospital Compare website, Kaiser Health News reports (Rau, Kaiser Health News, 7/18).

Background on Hospital Compare

In 2005, CMS began posting quality ratings for more than 3,000 U.S. hospitals on its Hospital Compare website.

The site first included data on adherence to basic clinical care guidelines and later expanded to include additional information, such as patient experience scores, readmission rates, mortality rates and complication rates (iHealthBeat, 4/25).

Details of Ratings Proposal

The ratings would be based on a selection of the 100 quality measures that the agency already makes public, according to KHN.

Although the proposal has yet to be formally introduced, CMS released a statement defending the idea.

"Visual cues can be an important way to help patients understand how their hospital measures up to others," the agency said. CMS requested input from the public about "user-friendly, creative designs for a rating system to help patients get information so they can take an active role in their care."

Critics Express Caution, Doubt

The proposed rating system has generated concern from some industry stakeholders.

In a letter to CMS, the Association of American Medical Colleges wrote that a star rating system "may make inappropriate distinctions for hospitals whose performance is not statistically different" or "exaggerate minor performance differences on measures."

Massachusetts General Hospital President Peter Slavin acknowledged that making medical standards more comprehensible for patients is a worthwhile pursuit, but he cautioned that an effective hospital rating system should be based on data that are more sophisticated. He said, "The quality information we're now using in health care is pretty crude and needs to get a lot better."

A large portion of the data on the Hospital Compare website is based on claims that hospitals submit to Medicare, which is "a lot like judging the quality of a restaurant from the checks they give to their customers," Slavin said.

"At some point if you oversimplify things, you're not providing people with information that is all that meaningful or helpful," Slavin said.

In addition, Leapfrog President Leah Binder pointed out that CMS' data are based on statistical tests that end up finding most hospitals indistinguishable from one another on major performance measures. For instance, nine out of 10 hospitals' mortality rates are described as "average" on the Hospital Compare website, she said.

"If their plan is to give the same number of stars to all hospitals, at best it will be boring. At worst it will be misleading," Binder said (Kaiser Health News, 7/18).

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