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Hospital star ratings skew lower in Michigan's impoverished areas, report says

Average of all one-star hospitals, immediate service base shows almost $21K less in household median income, 28.3 percent more in poverty.

Jeff Lagasse, Editor

The star ratings issued by the Centers for Medicare and Medicaid Services skew considerably lower for hospitals serving in Michigan's impoverished areas, according to a report from the Economic Alliance for Michigan.

CMS released its first ever star ratings for hospital quality through its Hospital Compare website in July, which are calculated using 64 of the 100-plus measures the agency monitors. In examining this data, EAM found evidence of lower quality of care and patient safety in areas that had higher percentages of poverty and unemployment, lower percentages of high school graduates and privately insured residents, and urban areas with a higher concentration of African Americans.

[Also: Anthem Blue Cross and Blue Shield's Medicare Advantage plans in Ohio score four stars]

In fact, the areas with the highest proportions of African Americans received an average of 1.2 fewer stars under CMS' system than those areas with the lowest number of African Americans. Unemployment rates were an indicator of wide discrepancy as well, with hospitals in areas of high unemployment trailing their other by an average of 0.9 stars, EAM said.

Michigan hospitals' average star rating is 3.1, with four hospitals garnering a one-star rating and four hospitals earning five stars. The average of all one-star hospitals and their immediate service base shows almost $21,000 less in household median income, 28.3 percent more in poverty, 9.4 percent more in unemployment, 12.8 percent fewer high school graduates and 36 percent fewer people with private insurance base when compared to five-star hospitals.

[Also: CMS hospital overall star ratings methodology flawed, Health Affairs says]

"The report raises a good point," said Bret Jackson president of EAM, in an accompanying statement. "Is CMS potentially punishing hospitals in areas that need the most help? We are champions for transparency in healthcare and like the idea of awarding hospitals who exceed expectations, but the thought of these one-star hospitals potentially losing federal dollars does not help in our cause of providing high quality of care and patient safety to all Michigan residents."

The results mirror a national trend: In September, Bloomberg News published similar findings in a nationwide assessment.

Twitter: @JELagasse