CMS recently updated its hospital quality star ratings on its Care Compare website, with more than 400 hospitals receiving five-star ratings.

How CMS calculates hospital star ratings

In 2020, CMS updated the methodology for its hospital star ratings, changing the number of measures considered and assigning hospitals to peer groups based on the number of measure categories they report. This year, the hospital star ratings are based on 47 quality measures across five different categories:

• Mortality (22%)
• Safety (22%)
• Readmission (22%)
• Patient Experience (22%)
• Timely and effective care (12%)

If a hospital reported no measures in a specific category, the weighted percentage was distributed proportionately to the other remaining categories.

For the latest rankings, CMS used hospital data through July 2021.

How hospitals performed

Of the 3,094 hospitals included in the rankings:

• 429 received a five-star rating, compared to 455 last year
• 890 received a four-star rating, compared to 988 last year
• 890 received a three-star rating, compared to 1,018 last year
• 693 received a two-star rating, compared to 690 last year
• 192 hospitals received a one-star rating, compared to 204 last year

An additional 2,205 hospitals did not receive a star rating due to a lack of available data.

Reaction

After the release of the rankings, the American Hospital Association (AHA) released a statement saying that while the methodology updates are good, more work still needs to be done.

"The AHA appreciates many of the recent changes that CMS has made to its Overall Star Ratings program, which have made the ratings easier for patients and hospitals to interpret, more transparent, and more balanced in favor of high-priority topics," said Akin Demehin, AHA's senior director of quality and patient safety policy. "However, we believe that CMS still has work to do to improve the Overall Star Ratings program."

"For example, while we agree with the intent of CMS' peer grouping approach – that is, to create a more level playing field among hospitals offering differing levels of care – we believe it still needs improvement to ensure it fosters equitable comparisons," Demehin said. "We also have encouraged CMS to examine the influence of social drivers of health on star ratings, and consider approaches to ensure the ratings are not unintentionally biased against those hospitals caring for structurally marginalized communities."

"Hospitals and health systems are longstanding supporters of transparency and are committed to continuing to work with CMS to advance the goal we share — providing the public with accurate, meaningful information about quality," he added. (Bean/Gleeson, Becker's Hospital Review, 7/28; AHA News, 7/27; Morse, Healthcare Finance News, 7/28; CMS Overall Hospital Quality Star Ratings, accessed 8/2)