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AHA: Understanding CMS’ Changes to Hospital Overall Star Ratings

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In 2020, the Centers for Medicare & Medicaid Services (CMS) overhauled the Hospital Overall Quality Star Ratings methodology with the expressed purpose of making ratings more transparent, equitable, stable and predictable. AHA commissioned KNG Health to assess whether these methodological changes have fully achieved CMS’ goals, while also estimating expected performance variation and drivers of performance and variation under the new methodology.

According to an AHA blog post relating to the report releases, the analysis revealed that while CMS’s new Overall Star Ratings methodology preserves some year-to-year stability, ratings remain volatile for hospitals reporting fewer measures. This was particularly true for smaller, rural hospitals and critical access hospitals (CAHs). The analysis also found that under CMS’ new peer grouping approach, 74% of hospitals are scored on all five measure groups, but the remaining 26% split across the 14 combinations of three to four measure groups — meaning a hospital’s star ratings can reflect very different sets of measure groups. This means these ratings still don’t provide an apples to apples comparison of hospitals.

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