StatLaw for April 2015

April 22, 2015

New CMS Hospital Quality Rating System

Question: How is the new CMS Hospital Quality Rating System calculated?
Answer: CMS’ new star rating system for hospitals is based on an average of a hospital’s performance on
eleven publicly reported measures from the Hospital Consumer Assessment of Healthcare Providers and Systems
(HCAHPS) survey. The HCAHPS survey includes patient evaluations of the hospital staff responsiveness, care
transitions, how well information about medications is communicated, and cleanliness and quietness of the
facility. The inaugural ratings came from patient responses gathered between July 1, 2013, and June 30, 2014.

However, healthcare organizations are not convinced that patient experience should be the primary way they are
ranked on quality. At the moment, the patient experience ranking is the only five-star rating displayed on the site,
even though CMS plans to include additional rankings in the future for achievements like patient safety and
clinical outcomes. Industry leaders are worried that patients will see the rating and select a facility based only on
one single, subjective measure of hospital quality, regardless of how they may fare clinically.

Under this patient-driven ratings system, only seven percent (7%) of hospitals received the coveted five stars
rating, while three percent (3%) achieved only one star. Thirty four percent (34%) received four star ratings, while
forty percent (40%) received three stars and sixteen percent (16%) received only two stars. Meanwhile, about
twenty percent (20%) of the nation’s hospitals are not ranked due to insufficient patient surveys. Under the new
ratings system, thirteen states and the District of Columbia do not have any five-star hospitals.

If you have any questions, please contact our Managing Partner, Michael J. Schoppmann, Esq at 1-800-445-0954
or via email at [email protected].