Only 251 Hospitals Score Five Stars in Medicare’s New Ratings

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US News World Report investigated national hospitals and reported on what the hospitals rated as under Medicare’s new guidelines.  This is the first time the federal government has awarded it’s first star ratings to hospitals based on patients’ appraisals.  Many of the nation’s high profile hospitals received mediocre ratings, while local hospitals and others that specialized in profitable surgeries frequently received the most stars. 

Many in the hospital industry worry Medicare’s five-star scale won’t reflect quality accurately and may place too much weight on patient reviews, which are just one portion of hospital quality. Medicare also reports the results of hospital care  but those are not yet assigned stars.  Nationally, Medicare awarded the top rating of five stars to 251 hospitals, about 7 percent of all the hospitals Medicare judged, a Kaiser Health News (KHN)analysis found. Many are small specialty hospitals that focus on profitable elective operations such as spine, heart or knee surgeries. They have traditionally received more positive patient reviews than have general hospitals, since general hospitals see a variety  of sicknesses and busy emergency rooms make it more likely patients will have a bad experience. 

A few five-star hospitals are part of well-respected systems, such as the Mayo Clinic’s hospitals in Phoenix, Jacksonville, Fla., and New Prague, Minn. Mayo’s flagship hospital in Rochester, Minn., received four stars.

Dr. Conway, chief medical officer for the Centers for Medicare & Medicaid Services, explained why they started with patient experience in the ratings system. “We want to expand this to other areas like clinical outcomes and safety over time, but we thought patient experience would be very understandable to consumers so we started there.”

Medicare’s new summary star rating, posted on Hospital Compare, is based on 11 categories of patient experience, including how well doctors and nurses communicated, how well patients believed their pain was addressed, and whether they would recommend the hospital to others. Hospitals collect the reviews by randomly surveying adult patients – not just those on Medicare — after they leave the facility. 

In assigning stars, Medicare compared hospitals against each other, therefore grading on a curve. It noted that “a 1-star rating does not mean that you will receive poor care from a hospital” and that “we suggest that you use the star rating along with other quality information when making decisions about choosing a hospital.” 

The American Hospital Association also issued a caution to patients, saying: “There’s a risk of oversimplifying the complexity of quality care or misinterpreting what is important to a particular patient, especially since patients seek care for many different reasons.” 

On average, hospitals scored highest in Maine, Nebraska, South Dakota, Wisconsin and Minnesota, KHN found. Thirty-four states had zero one-star hospitals.Hospitals in Maryland, Nevada, New York, New Jersey, Florida, California and the District of Columbia scored lowest on average. Thirteen states and the District of Columbia did not have a single five-star hospital.

In total, Medicare assigned star ratings to 3,553 hospitals based on the experiences of patients who were admitted between July 2013 and June 2014. Medicare gave out four stars to 1,205 hospitals, or 34 percent of those it evaluated. Another 1,414 hospitals—40 percent— received three stars, and 582 hospitals, or 16 percent, received two stars. Medicare did not assign stars to 1,102 hospitals, primarily because not enough patients completed surveys during that period. 

While the stars are new, the results of the patient satisfaction surveys are not. They are presented on Hospital Compare as percentages, such as the percentage of patients who said their room was always quiet at night. Until now Medicare did not indicate what differences it considered significant. In addition to the summary star rating, Medicare assigned stars to each of the patient satisfaction areas, but those stars are not as prominently displayed on its website. Medicare also uses patient reviews in doling out bonuses or penalties to hospitals based on their quality each year. 

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You can also see US News World Report hospital rankings for Florida here:

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