One possible symptom of hospital consolidation, exhaustion or confusion: Fewer have star ratings from the Centers for Medicare and Medicaid Services.
The number of hospitals that sent CMS enough of the right data to be graded on the agency’s five-star quality rating system fell to 2,847 this year, down 7.4% from the number that earned star ratings in 2023, according to an analysis of the 2023 and 2024 star rating Quality Updates and Specifications reports.
Star rating basics
CMS created the star rating system to try to give patients, health plans, brokers and hard-working benefits professionals a standardized, government-approved way to distinguish good hospitals from the ones where clients’ employees had better be careful about eating the tuna salad sandwiches.
The rating system includes measures grouped into five categories: mortality, safety of care, readmission, patient experience, and timely and effective care.
Good stars
This year, 381, or 13%, of the hospitals participating in the CMS star rating program earned top 5-star scores, down from 483 a year ago. The percentage with either 4 stars or 5 stars fell to 40%, from 42%. Was that drop the result of a measure change or one of those COVID things
Peering into the stars
Trying to dig into the numbers behind the CMS hospital stars is difficult.
One reason is that hospitals can decide which quality measures to report and how many to report. Hospitals that stay out of certain Medicare programs need not apply for ratings. To get rated, hospitals must send in data for at least three of the five major measure categories.
Once hospitals report the measure data, CMS uses moderately complicated math to convert the measure data into scores.
CMS analysts assume that the readers of their full reports are well-reversed in star rating methodology. They do not make it easy for novices to see what units the measures are in or, for specific measures, whether the good hospitals have positive numbers or negative numbers.
Although the number of hospitals participating fell this year, the percentage that submitted enough data to get graded in all five of the major measure categories, not just three or four, increased to 80%, from 79% last year.