Small hospitals may not have enough cases for accurate measurement, and in some cases, a number of the nation's best-known hospitals with the highest of ratings on other assessments, and that serve large numbers of low-income and complex patients, are slated to receive a small number of stars from CMS, they said. They want CMS to examine whether the flaws in the hospital-wide readmissions measure and the patient safety indicator (PSI-90) measure bias the rating against hospitals that care for more complex patients, the letter says. The main concern is the fairness and accuracy of social and economic factors and how this impacts hospital comparisons. In the letter to Conway, the hospital groups attached an analysis by an expert in econometrics stating that CMS' approach to overall hospital quality star ratings appears to have several shortcomings. Senators asked CMS to delay the publication of the star ratings program. This spring, the hospital groups and U.S. "Until CMS has taken the time to address these problems and share information with hospitals and the public demonstrating that its star ratings methods offer a fair and accurate assessment of hospital quality, we strongly urge the agency to continue to withhold publication of the flawed star ratings." The hospital groups want CMS to share additional information with hospitals and the public about how accurately star ratings portray hospital performance they urge CMS to address what they say are several significant underlying methodological problems with the star ratings. The Thursday letter was signed by the American Hospital Association, the Association of American Medical Colleges, America's Essential Hospitals and the Federation of American Hospitals. "We are deeply disappointed that we have not been given the opportunity to work with the Centers for Medicare and Medicaid Services to examine the serious concerns we have with its star ratings methodology, nor has CMS shared any data to demonstrate the validity of its methodology," they wrote to Patrick Conway, deputy administrator for Innovation and Quality for CMS.
Hospital organizations are blaming the Centers for Medicare and Medicaid Services for ignoring their concerns over the Hospital Compare star ratings program.
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