Issue link: https://beckershealthcare.uberflip.com/i/704703
16 QUALITY IMPROVEMENT & MEASUREMENT CMS Overall Star Ratings Have 'Several Shortcomings,' Analysis Finds By Heather Punke C MS' Overall Hospital Quality Star Ratings were supposed to be released in April, but the agency delayed the launch until July aer many stakeholders expressed concern with the program. Now, a new analysis of the program conducted by a Georgetown University economist found the program's methodology has "several shortcomings." Francis Vella, PhD, in Georgetown's De- partment of Economics in Washington, D.C., came out against the star ratings aer conducting an analysis of the program's methodology. Here are three of the methodology's main shortcomings, according to Dr. Vella's analysis: 1. e overall star ratings attempt to take a complex, multidimensional problem and put it into a simple measure, but Dr. Vella wrote he does "not see the net benefit" of doing so. 2. e methodology focuses solely on quality outcomes while ignoring their social deter- minants. "I feel ignoring other determinants of quality outcomes (such as location of hospital and patient composition) potential- ly biases the results," he wrote. 3. Finally, a star-based system can give a sense that a three-star hospital is substantially differ- ent from a four-star hospital, for instance, even when they are not that different. "Ranking the hospitals by stars is somewhat misleading as it indicates a qualitative jump as one goes from one category to the other and this may be inconsistent with reality and only reflects the scoring algorithm," Dr. Vella wrote. Dr. Vella isn't the only person or group to voice opposition to the overall star ratings program. Members from both the House and the Senate sent letters to CMS Acting Administrator Andy Slavitt earlier this year imploring him to delay the ratings, and many hospital advocacy groups did the same in March. Consumer groups like AARP, on the other hand, have expressed support for the overall star ratings, saying patients need this information to help make smart healthcare decisions for themselves. However, Rick Pollack, president and CEO of the American Hospital Association, asserts the ratings would be a hindrance to patients if released as-is. "As currently designed, CMS' star hospital ratings program is not up to the task of pro- viding the public with meaningful and accu- rate assessments of hospital performance," he said. "Patients need reliable information to make important choices regarding their healthcare. And hospitals and health systems need reliable information so that they can continue to improve the quality of the care delivered. CMS star ratings misses the mark on both accounts." n US News Changes Quality Measurements for Upcoming Hospital Rankings: 5 Things to Know By Brian Zimmerman T he 2016-17 U.S. News & World Report Best Hospi- tals rankings, scheduled to be published in August, will place less emphasis on the Agency for Health- care Research and Quality's Patient Safety Indicators when assessing hospitals for quality. The current U.S. News hospital rankings equally weigh seven AHRQ PSIs to generate a hospital's patient safety score, and that score accounts for 10 percent of the over- all score that determines a hospital's ranking across 12 specialties. After conducting a review of medical litera- ture, an internal data analysis and considering input from clinicians, researchers and healthcare administrators, U.S. News decided to make changes to the role PSIs play in their assessment of hospital quality. Here are five things to know about the new U.S. News hos- pital ranking methods. 1. Due to billing inaccuracies related to the PSI measure for pressure ulcers, this measure will no longer be consid- ered when assessing a hospital for safety. 2. The patient safety score's weighted influence on overall quality will be reduced from 10 percent to 5 percent. 3. The 5 percent weight reduction from PSIs will be offset with added weight to risk-adjusted survival, increasing this measure's significance from 32.5 percent to 37.5 percent. 4. Data from CMS will no longer be used when calculating PSI scores for Maryland hospitals because CMS reportage regarding these institutions contains incomplete patient admissions data. CMS data will be used to calculate PSIs for all states other than Maryland. 5. U.S. News will now use CMS's Standard Analytical Files instead of Medicare Provider Analysis and Review File when analyzing data on procedures. The SAF contains the date on which procedures are linked to a PSI event. This information will enable U.S. News to conduct a more sophisticated analysis by identifying events not incited by hospital error. n