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The Relationship between Hospital Characteristics and CMS Star Ratings

In April 2015, the Centers for Medicare & Medicaid Services (CMS) added Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) star ratings to Hospital Compare to further assist consumers in understanding patient experience information. The star ratings summarize results for each of the 11 HCAHPS measures and present that summary on a 5-star rating scale. Some hospital experts have suggested that such ratings risk increasing health care disparities for vulnerable patients through bias against certain types of hospitals. This data brief investigates links between hospital characteristics and HCAHPS star ratings.

Data Brief – The Relationship between Hospital Characteristics and CMS Star Ratings


  • Hospitals serving vulnerable patients receive lower star ratings.
  • Large, urban, teaching hospitals tend to receive lower star ratings.
  • Star ratings may exacerbate existing resource constraints for essential hospitals.
  • Further research is needed to understand the magnitude of the effect of hospital bed counts, teaching status, governance structure, and patient sociodemographic status on star ratings.


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