Senators want hospital star ratings delayed, press CMS to factor social, economic status

Lawmakers in the U.S. Senate on Tuesday sent a letter to Centers for Medicare and Medicaid Services acting administrator Andy Slavitt asking him to delay releasing the latest quarterly Hospital Compare rankings over concerns that the methodology used to rate hospitals fails to account for a patient pool's social and income-level standings.

The American Hospital Association is backing the 60 Senators, which include Republicans and Democrats, who sent the letter to Slavitt.

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"While we support the public reporting of provider quality data, we are concerned that the current Star Ratings system may not accurately take into account hospitals that treat patients with low socioeconomic status or multiple complex chronic conditions," the senators wrote, pointing to recent changes in rules for Medicare Advantage and Part B intended to deal with these types of issues.

The CMS star ratings are based on patient answers to the Hospital Consumer Assessment of Healthcare Providers and Systems surveys that are delivered after treatment. While CMS feels those scores represent a good overview of patient experience, the Senators and the the AHA argue the method is too simple.

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"Many hospitals that are in the top echelon of other quality ratings reports, and handle the most complex procedures and patients, may receive 1 or 2 stars (out of 5), indicating they have the poorest quality in comparison to all other hospitals," the letter said.

According to the AHA, a similar letter drafted by members of the U.S. House of Representatives will be delivered to CMS on Wednesday.

While CMS has said the ratings are based on the HCAHPS surveys, the lawmakers claim hospitals have been unable to replicate their star ratings on their own, suggesting there is more to the methodology.

Last week, CMS updated its star ratings for Medicare Advantage plans to adjust for plans that serve a disproportionate amount low-income beneficiaries.

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America's Essential Hospitals is also pushing for broad risk adjustments to ratings programs and any other CMS initiative that levies incentives or fines against a hospital tied to quality of care.

Central to the argument is data that shows lower-income patients often have less education and may only understand English as a secondary language, which can affect survey-based approaches to understanding patient experiences.

CMS releases its star ratings quarterly, and the next batch is due out this month.

Here is the letter:

Twitter: @HenryPowderly