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Association Expresses Concerns with Hospital Star Ratings

In a March 29 letter to the Centers for Medicare & Medicaid Services (CMS), America’s Essential Hospitals expressed its concerns with the underlying methodology and overall usefulness of overall hospital quality star ratings.

The letter was sent in response to a request for public input on the star ratings following the most recent refresh of the data on Hospital Compare in February.

In the letter, America’s Essential Hospitals encourages CMS to suspend publication of the ratings until issues with the underlying methodology are addressed to avoid confusion among patients and disproportionate effects on essential hospitals. In future star ratings updates, the association encourages CMS to:

  • ensure star ratings do not oversimplify a complex and individualized decision—a patients choice of care—while potentially exacerbating disparities in care;
  • include only reliable and valid measures when calculating star ratings, and risk adjust for factors outside the control of hospitals;
  • ensure measure grouping and group weights are balanced and reflect what matters to patients;
  • examine ways to account for differences among hospitals to ensure a level playing field and accurate reflection of care quality, including peer grouping;
  • re-examine the underlying statistical methods used in the ratings to improve their reliability, predictability, and accuracy; and
  • take strategic steps to ensure confidence, by all stakeholders, in the star ratings program and the information intends to provide.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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