Health and Science

Only about 2 percent of the nation's hospitals get 5-star quality rating

US Hospitals struggle to earn 5-star rating

Only a handful of U.S. hospitals have won a top rating under a new ranking system that reflects how well they provide patient care — but consumers will still have to wait a bit to learn which facilities earned that honor.

Federal health regulators on Thursday said that just 102 out of nearly 4,600 U.S. hospitals won an overall rating of five stars. That's only 2.2 percent of all hospitals.

The overall ratings reflect "comprehensive quality information about the care provided at our nation's hospitals," according to the federal Centers for Medicare and Medicaid Services, which released the data.

That information includes 62 quality measurements, for things such as care patients get for heart attacks and pneumonia, as well as the rate that patients get an infection after surgery, emergency room wait times and complication rates after hip replacements.

CMS said that 934 hospitals, or 20.3 percent, received a four-star overall hospital quality star rating.

The most common rating was three stars, which was received by 1,770 hospitals, or 38.5 percent. Another 723 hospitals, or 15.7 percent, received two stars.

Nearly 3 percent of the hospitals, 133, received just a one-star rating, the lowest possible score, according to CMS.

Another 937 hospitals, or more than 20 percent, were not assigned a rating. CMS said no star is assigned in cases of hospitals that do not report or do not have minimum amounts of data, which can occur if a facility is small or new, or has an insufficient number of cases.

CMS said an analysis of the new star ratings shows that high- and low-performing facilities are found across all types of hospitals.

For example, the five-star hospitals included 51 that have between one and 99 beds, another 19 that have 100 to 199 beds and 27 with 200 or more beds.

On the other hand, teaching hospitals accounted for 80 of the one-star hospitals, while nonteaching hospitals accounted for 53 that earned that rating.

So-called safety-net hospitals, which are either public facilities or private hospitals with relatively heavy Medicaid caseloads, had a median rating of 2.88 stars, which was slightly lower than the 3.09 stars that was the median rating for non-safety-net hospitals.

Hospitals since April 2015 have received quarterly quality star ratings from CMS for individual categories of care and patient experience. Those ratings are currently available through the CMS website Hospital Compare.

The new overall star ratings take the existing measurements reported on Hospital Compare, and summarize them into a a single star-based rating for a hospital. The system mirrors star ratings the CMS has been assigning to nursing homes, Medicare Advantage health plans, dialysis centers and home health services.

The partial data release about the star ratings comes three months after the originally scheduled April release. CMS postponed that release after Congress and the hospital industry pressured the agency to do so. Earlier in the year the American Hospital Association reportedly said the star rating system "oversimplifies the complexity of delivering high-quality health care."

CMS said it would take time during the postponement to listen to hospitals about their concerns with the rating system and answer any questions they had.

On Thursday, the agency said it "intends to post the Overall Hospital Star Ratings for individual hospitals shortly." Consumers then will be able to see the overall ratings at Hospital Compare.

The CMS "data continues to raise questions and concerns, as it may unfairly penalize teaching hospitals and those serving the poor. We urge CMS to work with the hospital field to ensure its methodology is fair and reliable, so that patients will have access to useful information," said Ashley Thompson, the American Hospital Association's senior vice president for public policy analysis and development.

The president of the advocacy group National Partnership for Women & Families in a blog post called the star ratings "a tool consumers need now."

"Every day, consumers make choices about which hospitals they or their families will use — and too often, they make those decisions without enough information to guide them," wrote Debra Ness, the group's president.

"Because they are unsure about where to go for trustworthy information on hospital quality, many make choices based only on a hospital's general reputation, the experiences of friends or where a physician has admitting privileges," she wrote.

"When it is implemented, the Hospital Star Ratings program will help give consumers more meaningful information to guide their decisions about which hospitals to use. It's the kind of comparative information consumers are accustomed to using when they make other important decisions or purchases," Ness wrote. "If needed, the program can be adjusted over time. But now is the time to move forward and give consumers a tool that will allow them to assess which hospitals do the best job of providing the care they need."