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CMS ratings said to lack key socio-economic data

 

The groups says that Medicare’s five-star scale that rates the quality of care doesn’t offer a complete picture because it fails to reflect these distinct  factors.

One way to address the problem, the groups say, is for CMS to add  income-related information into its ranking calculations. The star-rating system currently uses patient-satisfaction data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to determine the scores.

Beth Feldpush, senior vice president for policy and advocacy for America’s Essential Hospitals, told CMS that research warns  that larger hospitals, teaching hospitals and hospitals serving many low-income patients could well receive lower star ratings even though they provide quality care to the most vulnerable populations. She also complains  the system  oversimplifies complex and individualized choices that patients must make about their health.

She urged the agency to use  measures endorsed by the National Quality Forum that clearly  account for these socio-economic and demographic factors.

 


Safety-net hospital execs complain about new rating system

 

The Centers for Medicare and Medicaid Services is developing a hospital-quality star-rating system for the Hospital Compare Web site to provide currently available data on quality measurement to help inform healthcare decisions.The new  system will pull data from several sources, “which is different than the current system that’s based on the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, according to the CMS,” reports the publication.

“America’s Essential Hospitals, which represents 250 safety net hospitals around the country, said it’s concerned about the proposed methodology for the new system released by the agency earlier this year.

“We are not confident that the measures currently available on Hospital Compare enable CMS to create a single, methodologically sound rating of all aspects of hospital quality.”

“Although the intent of CMS, in developing an overall star-ratings system, is to provide patients with a simplified assessment of how hospitals perform overall on quality, each patient’s circumstances are different and the quality measures most relevant to their care will differ.”

“Also of concern is whether the system will take into account if a hospital serves more of a high-risk population. The trade group believes the CMS methodology should incorporate risk adjustment for socio-economic factors so results reflect differences in treatment across hospitals. ”

 


Delayed but deeper cuts for safety-net hospitals

 

For the third time in three years, federal cuts at safety-net hospitals have been delayed but the amount of  future cuts has been deepened.

An article on Governing Magazine’s Web site reports:

“America’s Essential Hospitals, a trade group for public hospitals, acknowledged there’s no returning to the level of DSH {Disproportionate Share Hospitals} spending before the ACA, but the stall in Medicaid expansion has certainly helped make their case that hospitals caring for the most vulnerable can’t sustain cuts. They also argue, however, that there’s evidence the ACA’s coverage expansions might not be enough, and the cuts go too deep. A study last year in the journal Health Affairs examined California, an enthusiastic supporter of the ACA, and found public hospitals there will have unmet DSH costs of more than $1 billion even by 2019.”

Such developments make adequate funding for such institutions as Federally Qualified Health Centers all the more important.


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