MARIA CASTELLUCCI February 28, 2019 10:10 AM
The CMS
is seeking comments from stakeholders on suggested changes to the hospital star
ratings even as the agency updates the Hospital Compare website with the newest
ratings after a nearly 15-month hiatus.
In a
press release Thursday morning, the CMS said a public comment page has opened
for stakeholders to provide feedback on the possibility that the agency will
separate hospitals into "peer groups" when comparing how they perform
on the 57 measures used to assign star ratings. The agency said hospitals could
be separated by bed-size and status like community or teaching. A CMS agency
official said the new comment period is in response to feedback from
stakeholders that the star ratings methodology needs to be changed in order to
better assess quality of care at hospitals.
"We
are putting out (this comment period) to get a greater breath of input on any
potential future changes that we might continue to make to the program,"
she added. But even as the CMS acknowledges opportunities to improve the
ratings system, the CMS official said she stands by the current star ratings as
a helpful tool for consumers.
The CMS
has been in hot water over its hospital star ratings since they first published
on Hospital Compare in July 2016. Hospital groups argue that the ratings
inaccurately depict quality of care at hospitals. The pushback hit a peak last
year after a preview of the July 2018 update had some hospitals seeing drastic changes to
their star ratings in just six months. The controversy led the CMS to withhold a new release
of the star ratings since December
2017.
The
suggestion to separate hospitals into peer groups addresses a common sticking
point for teaching hospitals who say they get low ratings because their
performance on measures is compared to specialty and small community hospitals
that don't have the same case mix, including patients with socioeconomic
challenges.
A Modern
Healthcare analysis last year
found that specialty hospitals receive disproportionately higher ratings than
teaching hospitals.
The
public comment period will end March 29.
The
latest star ratings update to Hospital Compare didn't see any changes from the
preview report the CMS released to providers in December, an agency official
said. At the time, hospital stakeholders expressed disappointment
that the February star ratings won't have substantial changes to the
methodology.
The one
change the CMS made to the February star ratings was how the
healthcare-associated infections measures used in the methodology were
weighted, which allowed those measures to have a greater impact on a hospital's
overall rating. The CMS also will remove measures that have statistically
significant negative loading from the star ratings, but that didn't happen in
the February star ratings release, the CMS official said.
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