On April 16th the Centers for Medicare & Medicaid Services (CMS) introduced its first star ratings of consumer satisfaction for hospitals. Hospital Compare, the agency’s public information website, makes it easier for consumers to choose a hospital and understand the quality of care and service provided. The CMS announcement described the program as "building on a larger effort across HHS to build a health care system that delivers better care, spends health care dollars more wisely, and results in healthier people."
The Hospital Compare star ratings relate to patients’ experience of care at almost 3,500 Medicare-certified acute care hospitals. The ratings are based on data from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) measures that are included in Hospital Compare. HCAHPS has been in use since 2006 to measure patients’ perspectives of hospital care, and includes topics like:
- How well nurses and doctors communicated with patients
- How responsive hospital staff were to patient needs
- How clean and quiet hospital environments were
- How well patients were prepared for post-hospital settings
Inpatient Prospective Payment System (IPPS) hospitals are required to report HCAHPS as part of the Hospital Inpatient Quality Reporting (IQR) Program and Critical Access Hospitals (CAHs) voluntarily participate.
Hospital Compare allows consumers to select multiple hospitals and directly compare performance measure information related to heart attack, heart failure, pneumonia, surgery and other conditions.
The Hospital Compare ratings are just one example of how CMS is now sharing data to help consumers make informed health care decisions. The Nursing Home Compare site already uses star ratings to help consumers compare nursing homes and choose one based on quality. Physician Compare has started to include star ratings in certain situations for physician group practices, and CMS recently added star ratings to the Dialysis Facility Compare site to help to make data on dialysis centers easier to understand and use. Star ratings are planned for Home Health Compare later this year.
Consumers will now see 12 HCAHPS Star Ratings on Hospital Compare, one for each of the 11 publicly reported HCAHPS measures, plus a summary star rating that combines or rolls up all the HCAHPS Star Ratings. These star ratings will be updated each quarter.
Based in part on these scores, hospitals can either lose or gain up to 1.5% of their Medicare payments in fiscal year 2015. CMS will up the ante over the next few years, with 2% of reimbursement dollars ultimately being at risk by fiscal year 2017.
For more information about the HCAHPS Survey please visit the official HCAHPS On-Line Web site.
Summary of HCAHPS Measures Used to Determine HCAHPS Star Ratings
There is a star rating for each of the following HCAHPS measures (drawn from questions on the HCAHPS Survey, as indicated):
- Communication with Nurses (Q1, Q2, Q3)
- Communication with Doctors (Q5, Q6, Q7)
- Responsiveness of Hospital Staff (Q4, Q11)
- Pain Management (Q13, Q14)
- Communication about Medicines (Q16, Q17)
- Discharge Information (Q19, Q20)
- Care Transition (Q23, Q24, Q25)
- HCAHPS Individual Items
- Cleanliness of Hospital Environment (Q8)
- Quietness of Hospital Environment (Q9)
- HCAHPS Global Items
- Overall Hospital Rating (Q21)
- Recommend the Hospital (Q22)