The federal government has released first of its kind hospital quality rating on Wednesday. The Centers for Medicare & Medicaid Services (CMS) rated 3,617 hospitals on a one- to five-star scale, one being the lowest quality of care and 5 being the highest quality of care, which has met with fair share of criticism from the medical industry. The argument has been that it is an unfair system and is urging the Obama Administration and Congress to block the rating system. Medicare awarded only 102 hospitals with the five-star rating, while 129 hospitals received rating of just one-star, while nearly half the hospitals received an average rating of 3 stars.

The number of stars each hospital receives is based on the quality of performance in 64 accounts of safety and performance standards which are mentioned on the Hospital Compare website. The standards include infection rates, death rates, readmissions, safety indicators and patient satisfaction scores. The goal is to offer consumers a simpler measure of hospital quality than the full listing of more than 100 separate measures reported by the government.

Within hours of the releasing the ratings, however, hospital performance experts reported that institutions that treated the most patients, meaning hospitals that had most data, scored far worse than those that treated fewer patients i.e., hospitals that were obscure and specialized in just a few types of surgeries, rendering their scores in certain categories unreliable.

The hospitals that typically scored lower were teaching and safety net hospitals that supply seriously ill patients with most advanced healthcare services. These facilities provided the most broad-spectrum services, devoted finances to latest research and technology and hired research oriented faculty. Moreover hospitals that catered to heavily sick patients were affected even though Medicare said it wouldn’t penalize them, but practically speaking these kind of risk assessments are tough to adjust when being rated, and do not offer a fair assessment.

Medicare also did not put into consideration the financial state of the patients being treated, since it’s clear that it plays a major role in the health outcome of an individual. Patients with strong financial backing recover quicker, do not need follow-ups as compared to those without financial support who have difficulty in surviving day to day expenses.

The rating system was to be made publically available on April 21, but was delayed so that Medicare could respond accordingly to widespread criticism of the ratings. Three of the nation’s major hospital organizations – the American Hospital Association, the Federation of American Hospitals, the Association of American Medical Colleges and America’s Essential Hospitals – had asked Medicare to delay its release to address their concerns. Nearly one-third of total hospitals could not be rated correctly since they had very minute patient databases, hence the government could not reliably measure the data.

Dr Kate Goodrich, who oversees Medicare’s medical quality rating analysis, said in a statement that she believes medical rating system to be useful. She said that the same rating system is put in place at dialysis centers, nursing homes and other medical facilities, and is quite useful for  patients when choosing a place. She further added that Medicare received numerous letters from national patient and consumer advocacy groups supporting the release of these ratings because it improves the transparency and accessibility of hospital quality information. In addition, researchers found that hospitals with more stars on the Hospital Compare website have tended to have lower death and readmission rates. She said, “Publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries.”

The Need For Public Healthcare Rating System

Patients and families are a source of measuring the quality of healthcare. Many healthcare facilities have online profiles where patients can rate their quality of healthcare services. So new patients can do a bit of research on a particular healthcare facility beforehand to make sure their service is up to scratch. Hence social media platforms can help patients research a public healthcare facility.

Moreover, since medical errors is the third leading cause of death in the US, according to a team of researchers from the Johns Hopkins University, not tracking vital stats properly can hamper research and public might not even be aware of the problem. A public healthcare rating system can make patients aware of the problems a specific hospital might face, and in case of extremely poor ratings, users might avoid that facility altogether.

An estimate of 9.2% of US patients acquire nosocomial infection. These infections are caused by pathogens in the air that can easily spread in the body. These infections can affect any patient that has been hospitalized and patients with weak immune systems. Hence, to combat such infections, which can become resistive to standard anti-biotic treatments, scientists are looking towards medical technology. Patients can read detailed reviews on poor facilities that have a history of nosocomial infection cases, and can safeguard their health.

Future Of Public Healthcare Rating System

CMS will continue to assess the star rating data and consider public feedback to make improvements to the scoring system as required. The star rating will be updated every three months, and will include new measures as they are publicly reported on the website as well as exclude measures retired from the quality reporting programs.

By releasing the Overall Hospital Quality Star Rating, CMS has taken a step forward in the right direction and made the data transparent and available to the general public. CMS has been posting star ratings for different facilities for a decade and have found that publicly available data allows medical improvement, reliable reporting, and more open access to quality information for Medicare users. CMS has promised to continue working closely with hospitals and other stakeholders to enhance the Overall Hospital Quality Star Rating based on feedback and experience.