Medicare's Hospital Compare adds star rating but
fails to score with critics
note: New star rating system gets some hoarse criticism at Kaiser Health
April 16, 2015 – Medicare’s Hospital Compare website may have added the
star rating system today but the new service – well, even the earlier
service – is not getting five stars from Jordan Rau of Kaiser Health
News. His article published today is below. It is a “must read” for
senior citizens planning on using the service to choose a hospital.
251 Hospitals Score Five Stars in Medicare's New Rating
By Jordan Rau, Kaiser Health News
In an effort to make comparing
hospitals more like shopping for refrigerators and restaurants, the
federal government has awarded its first star ratings to hospitals based
on patients’ appraisals.
Many of the nation’s leading
hospitals received middling ratings, while comparatively obscure local
hospitals and others that specialized in lucrative surgeries frequently
received the most stars.
hospitals is becoming increasingly important as more insurance plans
offer patients limited choices. Medicare already uses stars to rate
nursing homes, dialysis centers and private Medicare Advantage insurance
plans. While Medicare publishes more than 100 quality measures about
hospitals on its Hospital Compare website, many are hard to decipher,
and there is little evidence consumers use the site very much.
Many in the hospital industry fear
Medicare’s five-star scale won’t accurately reflect quality and may
place too much weight on patient reviews, which are just one measurement
of hospital quality. Medicare also reports the results of hospital care,
such as how many died or got infections during their stay, but those are
not yet assigned stars.
“There’s a risk of oversimplifying
the complexity of quality care or misinterpreting what is important to a
particular patient, especially since patients seek care for many
different reasons,” the American Hospital Association said in a
Medicare’s new summary star rating,
posted Thursday on its
website, is based on 11 facets of patient experience, including how well
doctors and nurses communicated, how well patients believed their pain
was addressed, and whether they would recommend the hospital to
others. Hospitals collect the reviews by randomly surveying adult
patients – not just those on Medicare — after they leave the facility.
In assigning stars,
Medicare compared hospital against each other, essentially grading on a
It noted on its
Hospital Compare website that “a 1-star rating does not mean
that you will receive poor care from a hospital” and that “we suggest
that you use the star rating along with other quality information when
making decisions about choosing a hospital.”
Nationally, Medicare awarded the
top rating of five stars to 251 hospitals, about 7 percent of all the
hospitals Medicare judged, a Kaiser Health News analysis found. Many are
small specialty hospitals that focus on lucrative elective operations
such as spine, heart or knee surgeries. They have
received more positive patient reviews than have general
hospitals, where a diversity of sicknesses and chaotic emergency rooms
make it more likely patients will have a bad experience.
A few five-star hospitals are part
of well-respected systems, such as the Mayo Clinic’s hospitals in
Phoenix, Jacksonville, Fla., and New Prague, Minn. Mayo’s flagship
hospital in Rochester, Minn., received four stars.
Medicare awarded three stars to
some of the nation’s most esteemed hospitals, including Cedars-Sinai
Medical Center in Los Angeles, New York-Presbyterian Hospital in
Manhattan, and Northwestern Memorial Hospital in Chicago. The
government gave its lowest rating of one star to 101 hospitals, or 3
On average, hospitals scored
highest in Maine, Nebraska, South Dakota, Wisconsin and Minnesota, KHN
found. Thirty-four states had zero one-star hospitals.
Hospitals in Maryland, Nevada, New
York, New Jersey, Florida, California and the District of Columbia
scored lowest on average. Thirteen states and the District of Columbia
did not have a single five-star hospital.
In total, Medicare assigned star
ratings to 3,553 hospitals based on the experiences of patients who were
admitted between July 2013 and June 2014. Medicare gave out four stars
to 1,205 hospitals, or 34 percent of those it evaluated. Another 1,414
hospitals - 40 percent - received three stars, and 582 hospitals, or 16
percent, received two stars. Medicare did not assign stars to 1,102
hospitals, primarily because not enough patients completed surveys
during that period.
While the stars are new, the
results of the patient satisfaction surveys are not. They are presented
on Hospital Compare as percentages, such as the percentage of patients
who said their room was always quiet at night. Often, hospitals can
differ by just a percentage point or two, and until now Medicare did not
indicate what differences it considered significant. The Centers for
Medicare & Medicaid Services (CMS)
also uses patient
reviews in doling out bonuses or penalties to hospitals based
on their quality each year.
Some groups that do their own
efforts to evaluate hospital quality questioned whether the new star
ratings would help consumers. Evan Marks, an executive at Healthgrades,
which publishes lists of top hospitals, said it was unlikely consumers
would flock to the government’s rating without an aggressive effort to
make them aware of it.
“It’s nice they’re going to trying
to be more consumer friendly,” he said. “I don’t see that the new star
rating itself is going to drive consumer adoption. Ultimately, you can
put the best content up on the Web, but consumers aren’t going to just
wake up one day and go to it.”
Jean Chenoweth, an executive at
Truven Health Analytics, which also publishes its own list of top
hospitals, said she feared hospital marketing departments would oversell
the meaning of the stars. “It would be very unfortunate and misleading
if a hospital marketing department could claim to be a CMS five-star
hospital and fail to mention it only reflected a patients’ perception of
care,” she said.
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