Becker's Hospital Review

48 CMO / CARE DELIVERY CMS Updates Overall Hospital Star Ratings: 5 Things to Know By Brian Zimmerman C MS updated its Overall Hospital Quality Star Ratings on its Hospital Compare website Dec. 21, after a five-month delay. Here are five things to know. 1. CMS' Hospital Compare website reports quality measures for more than 4,000 hos- pitals nationwide. CMS overall star ratings assigned to hospitals are based on 57 quality measures across seven areas of performance: mortality (seven measures), safety of care (eight measures), readmission (nine mea- sures), patient experience (11 measures), ef- fectiveness of care (10 measures), timeliness of care (seven measures) and the efficient use of medical imaging (five measures). 2. e agency delayed the release of the rat- ings since July to retool its methodology and collect feedback. While praised by consumer groups, the ratings have drawn sharp critique regarding the quality of its methodology from multiple stakeholder organizations, including the American Hospital Association. 3. CMS said the new ratings are the result of recommendations from a panel of technical experts and public feedback. "We continue to refine the star ratings and look forward to an ongoing dialogue with hospitals and patients and their families on how we can provide beneficiaries useful in- formation," said CMS Administrator Seema Verma. 4. Changes to the new ratings are summarized in a specifications report. e report details 67 measures excluded for a number of reasons, including overlap with already existing mea- sures and measures with 100 or fewer hospitals reporting. ese measures include emergency department volume, prescribing aspirin at dis- charge and catheter-associated urinary tract infection in the intensive care unit. 5. Changes in the specific methodology used to stratify the ratings include the removal of winsorization from the statistical breakdown. Winsorization is a process that limits extreme values from arising in statistical analysis. As a result, the new ratings have a higher number of 5-star and 1-star hospitals. Here's a breakdown of how the new star rat- ings compare to those issued by CMS in De- cember 2016: • Five stars: 337 in December 2017 (83 in December 2016) • Four stars: 1,155 (946) • ree stars: 1,187 (1,794) • Two stars: 753 (694) • One star: 260 (112) n CMS Cuts Payments to 751 Hospitals for Patient Injuries: 5 Things to Know By Ayla Ellison C MS will cut 751 hospitals' Medicare payments in fiscal year 2018 for having the highest rates of hospital-acquired conditions. Here are six things to know about the HAC Reduction Program and the hospitals receiving penalties. 1. Created under the ACA, the HAC Reduction Pro- gram aims to prevent harm to patients by providing a financial incentive for hospitals to prevent hospital-ac- quired conditions. Under the program, a hospital's to- tal score is based on performance on six quality mea- sures: central-line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, methicillin-resistant Staphylococcus au- reus infections, Clostridium difficileinfections, and the Patient Safety Indicators 90 Composite, which includes 10 types of in-hospital injuries. 2. Each year, Medicare cuts payments by 1 percent for hospitals that fall in the worst-performing quartile. In fiscal year 2018, 751 hospitals will have their Medicare payments reduced. 3. As in past years, many of the nation's academic med- ical centers were penalized under the program. Ac- cording to a Kaiser Health News analysis, 115 teaching hospitals will have their payments reduced in fiscal year 2018. 4. Hospitals that serve poorer and sicker patient popu- lations were also fined more than hospitals with a more affluent patient base. Approximately one-third of safe- ty-net hospitals evaluated under the HAC Reduction Program were penalized in fiscal year 2018, according to Kaiser Health News. 5. The hospital industry has argued the methodology used for the HAC Reduction Program doesn't recognize improvement, because roughly 700 hospitals will lose money every year even if they improved their safety re- cords, according to Kaiser Health News. n

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