Thursday, July 28, 2016

Feds issue ratings on 3,662 hospitals, 82 in Ky.; none get top rank, 16 get second rank; industry says ratings oversimplify

By Danielle Ray
Kentucky Health News

The Centers for Medicare and Medicaid Services on Wednesday released its Overall Hospital Star Ratings, just two days after two U.S. House members introduced a bill that would delay the release for a year.

The ratings aim to give consumers a simple measure of hospital quality. Critics say they are too simple.

They rate 3,662 U.S. hospitals from one to five stars, with the latter representing the highest quality of care. Each hospital's rating is based on 64 measures of safety and performance in seven categories: mortality, safety of care, readmission within 30 days, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging.

"These easy-to-understand star ratings are available online and empower people to compare and choose across various types of facilities from nursing homes to home health agencies," Dr. Kate Goodrich, director of Medicare's Center for Clinical Standards and Quality, said Wednesday on CMS's official blog.

Many hospital performance experts have opposed the rankings, calling them skewed and unreliable.

"Hospitals that reported on the majority of metrics tended to get one, two or three stars," Dr. Janis Orlowski, chief healthcare officer of the Association of American Medical Collegestold Steve Sternberg of U.S. News & World Report. "Hospitals that reported on less than 40 percent of the metrics accounted for almost half of those that got five stars."

CMS planned to release the ratings April 21, but delayed them so Medicare officials could respond to criticism, which included a letter from 60 of the 100 U.S. senators and 225 of the 438 representatives calling for a delay, plus pressure from some of the nation's largest hospital organizations.

Two days before the release, Reps. James Renacci (R-Ohio) and Kathleen Rice (D-New York) introduced a bill that would have forced its delay until at least July 2017.

“I still have real concerns that this system could unfairly penalize teaching hospitals and hospitals that serve poor communities, and that patients will ultimately pay the price," Rice told Elizabeth Whitman of Modern Healthcare.

That may have been reflected in the Kentucky rankings. The hospitals at the University of Louisville and University of Kentucky got one star and two stars, respectively.

The agency chose to go ahead with the release, Goodrich said in the CMS blog, because officials "have received numerous letters from national patient and consumer advocacy groups supporting the release of these ratings." She said the ratings improve transparency and accessibility of information about hospital quality.

Of the 94 Kentucky hospitals that CMS evaluated, 82 were rated, and 12 did not have enough data to generate a rating.

Twin Lakes Regional Medical Center (Photo from
No Kentucky hospital earned a five-star rating. Sixteen hospitals got four stars: Baptist Health Lexington, Baptist Health Louisville, Casey County Hospital in Liberty, Clark Regional Medical Center in Winchester, Flaget Memorial Hospital in Bardstown, Greenview Regional Hospital in Bowling Green, Hardin Memorial Hospital in Elizabethtown, Harrison Memorial Hospital in Cynthiana, Marcum and Wallace Memorial Hospital in Irvine, Methodist Hospital in Henderson, Pineville Community Hospital, St. Joseph Martin, St. Elizabeth Fort Thomas, St. Elizabeth Medical Center North in Edgewood, TJ Health Columbia (now only a behavioral-health facility) and Twin Lakes Regional Medical Center in Leitchfield.

The majority of the Kentucky hospitals rated, 52, earned three stars. A complete list of those hospitals can be found here.

Twelve hospitals got two stars: Ephraim McDowell Regional Medical Center in Danville, Harlan Appalachian Regional Healthcare Hospital, Hazard ARH Regional Medical Center, Jennie Stuart Medical Center in Hopkinsville, Jewish Hospital & St. Mary's Healthcare in Louisville, Kentucky River Medical Center in Jackson, Lourdes Hospital in Paducah, Monroe County Medical Center in Tompkinsville, St. Joseph Hospital in Lexington, St. Joseph East in Lexington, St. Claire Regional Medical Center in Morehead and the University of Kentucky Hospital.

Two hospitals earned just one star: University of Louisville Hospital, where a recent state inspection found problems with nursing; and Lake Cumberland Regional Hospital in Somerset, which ranked very poorly in the 2014 ratings by Consumer Reports magazine. It got two stars last year, one of only six Kentucky hospitals to do so.

Rick Pollack, president and CEO of the American Hospital Association, said he fears the ratings could mislead patients.

"The new CMS star ratings program is confusing for patients and families trying to choose the best hospital to meet their health care needs," Pollack said in a news release. "Health care consumers making critical decisions about their care cannot be expected to rely on a rating system that raises far more questions than answers."

A comprehensive list of Kentucky hospital CMS ratings can be found here. Nationally, Medicare gave five stars to 102 hospitals, four to 934 hospitals, three stars to 1,770 and one star to 133. Many hospitals did not produce enough data in the measured areas to warrant a rating.

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