CMS Delays Hospital Star Ratings Update, Again

Policymakers say they need more time to analyze the impact of the changes on hospitals. However, some related metrics will be updated by the end of July.

Citing "stakeholder concerns," the Centers for Medicare & Medicaid Services has once again postponed an update to its Overall Hospital Quality Star Ratings.

"When changes are made to the underlying measures it is vital to take the time needed to understand the impact of those changes and ensure we are giving consumers the most useful information," CMS said Tuesday in a posted notice.

"As part of this process, CMS will seek feedback from a multi-disciplinary Technical Expert Panel, a Provider Leadership Workgroup, and a public comment period," CMS said.

No date was given for when CMS anticipates activating the ratings updates. Typically, the updates are issued every July and December. However, CMS has a history of delaying the updates, most recently in May.

News of the pushback was well-received by hospital stakeholders.

"CMS made the right call," said Tom Nickels, executive vice president of the American Hospital Association. 

"We appreciate the agency allowing more time for a fuller analysis of its methodology and measures and to hear from stakeholders, including hospitals and health systems, about concerns found in many preview reports," Nickels said.

Bruce Siegel, MD, president and CEO of America's Essential Hospitals, welcomed the delay and said that stakeholder reviews of the proposed July updates showed "large shifts in overall hospital star ratings from December 2017 to July 2018."

"These changes have created confusion and raised new questions about the reliability and validity of the methodology used to calculate these ratings," he said.

"We remain deeply concerned the star ratings could do more harm than good in their current form. We look forward to working with CMS to ensure patients and their families can make care decisions based on accurate and meaningful data," he said.

CMS said it will update these metrics on July 25:

• Outcome measures for 30-day mortality, 30-day readmissions, and CMS Patient Safety Indicators, including:
   
• Outpatient imaging efficiency;
   
• Payment and value of care;
   
• Timely and effective care;
   
• Healthcare-associated infections;
   
• HCAHPS surveys.

CMS will add three new measures to Hospital Compare:

• Hospital return days for pneumonia patients (EDAC-30-PN);
   
• Percentage of patients who received appropriate care for severe sepsis and septic shock (SEP-1);
   
• Average time patients spent in the emergency department before being sent home (OP-18c), which will only be reported on data.medicare.gov

CMS is no longer reporting the Pain Management composite 4 on Hospital Compare or in the downloadable databases. This composite measure is also being excluded from the calculation of the HCAHPS Summary Star Rating for the July Hospital Compare release.

In addition, CMS said it:

• Will not publish the Overall Hospital Star Rating from the July Preview Reports on Hospital Compare.
   
• Will Post the SAS Pack with the next Star Ratings refresh on Hospital Compare.
   
• Will keep Star Ratings released in December 2017 on the Hospital Compare until the next update.