CMS Hospital Ratings Don’t Tell the Whole Story
Posted by Kurt Stuenkel, President and CEO
August 15, 2016
The Centers for Medicare and Medicaid Services (CMS) released its first hospital star ratings recently. It’s the federal government’s attempt with the mountains of hospital data they collect to create a single rating that helps health care consumers.
Floyd earned three stars–certainly respectable, but we would never advise someone to focus on a single rating when making an important health care decision. This is especially true in the case of the CMS ratings, which do not differentiate between sizes of hospitals, services offered, or patient population. As an organization, we use many different scorecards and methods to measure and improve quality and some of these can be helpful and meaningful to both hospitals and consumers.
The Hospital Compare data that CMS uses to arrive at these star ratings are not well suited to creating a single, statistically sound representation of a hospital’s quality.
Casey Ross, a reporter for the online health care magazine, STAT, pointed out that teaching hospitals and safety net hospitals, like Floyd, don’t fare as well in the CMS ratings, likely because they tend to deal more with sicker, low-income patients.
Ross quoted J.B. Silvers, Case Western Reserve University professor of health care finance, who says the CMS star ratings are biased:
“Big teaching hospitals are taking care of the most complex cases,” Silvers said. “Hardly any of them are in the five-star category. Most of them are in the one-star category.”
Lois Norder, an investigative journalist with the Atlanta Journal Constitution, summed up the problem with a question:
“Next time U.S. hospitals must respond to a disease like Ebola, is Gordon Hospital in Calhoun, Georgia — population 15,650 — the place to send patients? Should ambulances head to the 100-bed Northside Medical Center in Columbus if a horrific accident injures motorists on I-85 there?”
Gordon and Northside are the only two Georgia hospitals to receive a five star rating from CMS. Emory University Hospital, which treated the nation’s first Ebola patient, received only two stars, and Grady, arguably the most experienced Level 1 trauma center in the state, received a rating of one star.
In her article, Norder quoted Dr. Kate Goodrich, director of the CMS Center for Clinical Standards and Quality, who admitted the ratings don’t tell the whole story and are designed to reflect routine care for the average patient.
“Specialized and cutting edge care that certain hospitals provide, such as specialized cancer care, are not reflected in these quality ratings,” Dr. Goodrich said.
And therein lies the problem. Most hospital care is specialized. In modern health care, hospitalized patients are usually there because their routine health condition has escalated to a point that requires the intervention of a specialist.
Floyd relies on accrediting bodies, like The Joint Commission, and quality measuring organizations like Healthgrades® and Comparion® for quality information. These organizations use quality data from multiple sources to compare hospitals and rate them in specialty areas that provide a more accurate comparison.
These organizations show Floyd doing quite well. Floyd is accredited by The Joint Commission and has been recognized by Healthgrades with its Patient Safety Excellence Award for three consecutive years, including 2016. Healthgrades currently ranks Floyd in the top 5 percent nationally for patient safety. CareChex®, a division of Comparion, recognized Floyd in 2016 for being in the top 10 percent in the nation for Patient Safety and Medical Excellence in Overall Hospital Care and for being among the top 100 hospitals in the nation for Patient Safety in Overall Surgical Care. Floyd’s quality data from Comparion also shows us to have low rates of mortality and complications.
We are proud of this recognition, because it reflects our hard work. Floyd continuously monitors quality data and outcomes in all of our service lines, and we work with these organizations to help ensure our patients receive excellent care that is safe and evidence-based.
Rather than look at a single rating, we encourage health care consumers to compare facilities side-by-side, using multiple sources. When choosing a hospital, ask family, friends, physicians and other health care providers which facility they use. It is also useful to look at specific measurements in the specific area of need, for example, stroke, hip replacement, or heart care. And never forget that one of the best sources of information is your own family physician. If you, a family member or friend has questions, you can ask us using the comment section below.