The Centers for Medicare and Medicaid Services has been reporting hospital star ratings since 2016, however the star ratings methodology does not adjust for social risk factors. A new study, published in Health Affairs, examined the relationship between 2021 star rating scores and hospitals’ proportion of Medicare patients dually eligible for Medicaid.
The study found that, on average, hospitals caring for a greater proportion of dually eligible patients had lower star ratings, but there was significant overlap in performance among hospitals when they stratified them by quintile of dually eligible patients. Hospitals in the highest quintile (those with the greatest proportion of dually eligible patients) had the best mean mortality scores but the worst readmission and patient experience scores. When researchers assigned star ratings after stratifying the readmission measure group by proportion of dually eligible patients, they found that a total of 142 hospitals gained a star and 161 hospitals lost a star.
- Assessing Hospital Quality Scores By Proportion Of Patients Dually Eligible For Medicare And Medicaid. Health Affairs. January 2023