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For better or worse, the Centers for Medicare & Medicaid Services (CMS), part of the Department of Health and Human Services, recently released overall hospital quality star ratings. Smaller hospitals seemed to do better than some of the large-system hospitals. But what do these ratings really tell us? Here is some basic information about the ratings
The ratings are a composite metric of one to five stars (five is the best).
- The CMS uses 64 measures — including patient communication, emergency room wait times and hospital-acquired infection rates — to grade nearly 4,000 hospitals on their overall quality.
- The goal of the ratings process is to enable patients to compare and choose across various types of health facilities.
According to the CMS, 102 facilities out of 4,599 hospitals, or 2.2 percent, earned five stars. Of the rest, 20.3 percent received four stars, 38.5 percent earned three, 15.7 percent attained two stars and 2.9 percent received a single star. About 20.4 percent of hospitals didn’t receive ratings because they lacked data or didn’t provide data to measure results.
Not everyone, however, agrees with the process and resulting star ratings. Hospitals and other industry groups have been critical of the CMS for using a system that may oversimplify a complex matter. Critics warned the CMS that the star system would provide inaccurate information to consumers and could damage hospitals’ reputations. In fact, some critics think the star system unfairly penalizes teaching hospitals and those serving higher numbers of the poor.
Like every issue, there can be multiple sides to the story. While the CMS survey is not without flaws, it does provide some ability for consumers to contrast and compare to ensure they are receiving the best possible care at a reasonable cost. And the results are easily accessible online. However, the critics raise good points about teaching hospitals and those serving higher numbers of the poor.
Sometimes, of course, the ratings may not matter if patients don’t have the ability to travel to a facility with a higher star rating. And patient needs may vary. For instance, perhaps access to a particular doctor or medical team through an appointment or referral is more important to a patient than emergency room wait times, one of the measures in the study.
While the variables and preferences are many when it comes to healthcare, an element that hospitals and related facilities have in common is the ability to influence satisfaction around patient communication. I would argue that it’s the most important element when it comes to patient experience.
If your facility is interested in higher star ratings, your medical professionals should be encouraging patients to tell their stories. They should be taking the patient’s problem seriously, explaining information clearly and providing options to the patient. Research has shown strong positive relationships between a healthcare team member’s communication skills and a patient’s ability to follow through with medical recommendations. This type of patient communication is what leads to good health outcomes, as well as patient satisfaction with the experience.
How do you compare? Most importantly, how do you plan to communicate to your patients and the community you serve about your rankings? If you need help in managing patient expectations, give us a call.