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Issues With the Initial CMS Star Ratings
The July 2016 CMS Overall Hospital Quality Star Ratings system combined 64 hospital quality measures from Hospital Compare into “measure groups”: mortality, safety of care, readmission, patient experience, effectiveness of care, timeliness of care, and efficient use of medical imaging. A latent variable modeling approach was applied to weight the measures within each group, and overall scores were calculated. A statistical approach (k-means clustering) sorted hospitals into final ratings ranging from 1 to 5 stars. All eligible hospitals in the country (N = 3591) were measured against each other, including large academic medical centers (n = 228), community hospitals of all sizes (n = 1719), critical access hospitals (n = 544), and even single-specialty hospitals (eg, orthopedic) (n = 79).