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AAMC Submits Comments on Proposed Enhancements to Hospital Star Ratings Methodology

September 29, 2017—The Association of American Medical Colleges (AAMC) submitted comments Sept. 27 to the Centers for Medicare and Medicaid Services (CMS) regarding enhancements to the star ratings methodology. The AAMC noted that “Until CMS is able to address significant concerns with the methodology used to assign star ratings, the AAMC calls on the Administration to remove the star ratings from the Hospital Compare website.” In the letter, the AAMC expresses concerns about the potential consequences for patients that could result from painting an overly simplistic picture of hospital quality with the star rating system. 

As CMS reexamines its methodology for star ratings, AAMC also made the following specific recommendations to CMS:

  • Explore measure performance within specific peer cohorts so that hospitals with similar characteristics and risk profiles are compared to each other.
  • Remove hospitals that do not report enough measures or domains from the star ratings.

  • Remove the PSI-90 composite measure from star ratings and the hospital-wide readmission measure.

  • Justify the weights for each measure group based on the integrity of the measures and the importance of the particular category overall in determining the hospital’s performance.

  • Provide a more complete impact analysis of each proposal to allow additional transparency to stakeholders as they evaluate improvements to the program.

CMS responded Sept. 27 that it will not update the Overall Hospital Quality Star Ratings in October, as previously scheduled. Instead, it will continue to examine potential changes to the Star Rating methodology.


Gayle Lee
Director, Physician Payment & Quality
Telephone: 202-741-6429


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Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

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Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806