Healthcare Transparency Bill Proposes to Delay Star Ratings
House Representatives have introduced a healthcare transparency bill that would defer the release date of the CMS hospital quality star ratings system.
By - Two House Representatives, Jim Renacci (R-OH) and Kathleen Rice (D-NY), have recently introduced a healthcare transparency bill that would require CMS to delay the release of new hospital star ratings for another year to ensure that the program’s methodology is fair and accurate.
A summary of the Hospital Quality Rating Transparency Act of 2016 (via AHA News Now) details proposed provisions that call on CMS to defer the introduction of the new ratings system until no earlier than July 31, 2017. During that time, CMS would have to accept stakeholder comments for a 60-day period regarding the program’s methodology and the data used to calculate the ratings.
The bill would also mandate that a third party validate the star ratings system’s methodology and data.
In the event that CMS publishes the star ratings before the bill is enacted, it would require the agency to remove the ratings from the Hospital Compare website.
The American Hospital Association (AHA) commended Representatives Renacci and Rice for introducing the bill, especially since the industry group had urged CMS to address issues with the star ratings methodology earlier this month.
“Patients need clear, meaningful information to make important healthcare decisions,” stated AHA Executive Vice President Tom Nickels in a public statement. “Yet, thus far, it is unclear whether the Centers for Medicare & Medicaid Services’ (CMS) star ratings actually provide accurate and reliable data to the public.”
Nickels explained that AHA’s analysis of preliminary data for the star ratings system may unjustly penalized teaching hospitals and healthcare facilities that serve low-income patients.
“We continue to urge CMS to work with hospitals and health systems to provide patients with a rating system that accurately reflects the quality of care provided at their facilities, and will work with Reps. Renacci and Rice to move this legislation forward,” Nickels added.
CMS proposed to add a star ratings quality system on its Hospital Compare website in April to boost healthcare transparency and help consumers make more informed decisions about their healthcare.
The agency evaluates hospitals one a scale of one to five stars, with five representing the highest quality. Hospitals are assessed based on patient survey results, timely and effective care, readmissions, complications and deaths, use of medical imaging, tying care quality to payment, and Medicare volume.
Due to stakeholder and Congressional feedback, CMS delayed the initial release of the star rating until the end of July.
Specifically, 225 members of the House of Representatives penned a letter to CMS in April calling on the agency to delay the release of the star ratings because its methodology does not include relevant quality measures for assessing hospitals that care for more medically complex patients.
The Representatives advised CMS to include quality measures, such as chronic disease management and socioeconomic status of patients, to prevent downgrading hospitals that handle complicated patient mixes.
The star ratings system overemphasizes the patient experience and neglects important clinical quality measures, reported the Representatives.
“We are concerned that the hospital star ratings, in their current form, may be unfairly masking quality or, possibly, over-weighting of patient experience measures and will therefore not help consumers make well-informed decisions about which hospitals to use,” the letter stated.
Additionally, the letter explained that the methodology lacked transparency because hospitals did not have the “necessary data used to replicate or evaluate CMS’s work to ensure that the methodology is accurate or fair.”
Sixty senators also wrote a similar letter to CMS in April citing a lack of relevant clinical quality measures and healthcare transparency as reasons for delaying the ratings publication.
“We are concerned that the Star Rating system may be misleading to consumers due to flaws in the measures that underpin the ratings,” wrote the senators. “Many prominent hospitals that are in the top echelon of other quality rating reports, and handle the most complex procedures and patients, may receive 1 or 2 stars (out of a possible 5), indicating that they have the poorest quality in comparison to all other hospitals.”
While CMS is working to empower healthcare consumers to take a leading role in their healthcare decisions through the star ratings, some industry groups have disagreed with how hospitals are assessed for quality, which could affect patient revenue.
Dig Deeper:
• CMS’s Clinical Quality Measures a Top Priority
• Is CMS’S Hospital Quality Star Rating System Non-Compliant?
