The Centers for Medicare and Medicaid Services (CMS) Feb. 28 released updated Star Ratings as part of a broader refresh to the hospital quality data publicly available on the Hospital Compare website. As part of the February 2019 update, CMS also released a public comment period for potential improvements to the Star Ratings methodology.
CMS seeks feedback on specific near-term updates it is considering for implementation, as well as comments on items for future consideration. These potential updates to the methodology are intended to address stakeholder concerns and to make the Star Ratings less sensitive to changes in measures or the underlying data. Possible improvements include:
- Presenting the rating results within peer groups, for example peering by hospital type (safety net, teaching hospitals, small/rural/Critical Access Hospitals, etc.) or by bed-size.
- User-customizable ratings allowing users to see updated ratings results based on the user’s inputs for measure group weightings based upon the individual user’s values.
- Ideas to improve consistency and predictability of the Star Ratings:
- Alternative approaches to accounting for measure precision;
- Enhancement of the measure grouping process to improve model performance and face validity;
- Creation of a direct calculation to improve calculation time and score precision instead of using a statistical model; and
- Reducing the magnitude of Star Ratings shifts between periods:
- Use of a rolling weighted combination of current and previous data, and
- Align Star Ratings refreshes with annual Hospital Compare reporting.
The AAMC will submit comments, which are due by March 29. The AAMC has previously submitted comments to CMS on how the agency could make changes to its methodology to enhance the ratings [see Washington Highlights, Sept. 29, 2017].