Reps. Pascrell, Renacci Call for CMS STARS Delay
WASHINGTON, D.C. – Today, U.S. Reps. Bill Pascrell, Jr. (NJ-09) and Jim Renacci (OH-16) along with 223 other members – sent a letter to the Centers for Medicare and Medicaid Services (CMS) urging CMS to delay the release of the hospital star ratings until they are able to provide more information about the methodology used to determine the scores. Reps. Pascrell and Renacci are both members of the Ways and Means Committee and Budget Committee.
“We are concerned that the hospital star ratings, in their current form, may be unfairly masking quality…and will therefore not help consumers make well-informed decisions about which hospitals to use. A number of the quality measures that underpin the ratings unfairly impact teaching hospitals that treat low socioeconomic status patients, more complex patients, and perform a greater number of complicated surgeries,” the members wrote in the letter.
“We want to ensure Americans are receiving the best quality of care they need. Therefore, we need to verify that the star rating system is not misleading to consumers because of flaws in the measures that underpin the ratings. When Americans choose which hospital will best accommodate their needs, they deserve the most accurate information to make that decision,” Renacci and Pascrell, leaders of the letter, explained.
The Centers for Medicare & Medicaid Services (CMS) has developed a plan to consolidate quality measure data reported on the Hospital Compare website into a five star ratings system to assess hospital quality. These star ratings, which are set to appear on the Hospital Compare website later this month, aim to make it easier for consumers to use the information on the Hospital Compare website and to spotlight excellence in healthcare quality.
Text of the letter is below and available here as a PDF.
The Honorable Andy Slavitt
Acting Administrator
Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
7500 Security Boulevard
Baltimore, MD 21244
Dear Acting Administrator Slavitt:
We are writing to express some concerns with the hospital star rating system that CMS plans to publicly release in April 2016. While we strongly support public reporting of provider quality data, we urge you to ensure that this data adequately accounts for hospital patient mixes that include higher proportions of patients with multiple complex chronic health conditions and lower socioeconomic status. We also request that you provide hospitals with more details on the methodology used to determine their star ratings.
We want to make sure that the star rating system is not misleading to consumers because of flaws in the measures that underpin the ratings. As you know, many prominent hospitals that are in the top echelon of other quality rating reports, and handle the most complex procedures and patients, will receive one or two stars (out of a possible five), indicating that they have the poorest quality in comparison to other hospitals.
We are concerned that the hospital star ratings, in their current form, may be unfairly masking quality or, possibly, over-weighting of patient experience measures and will therefore not help consumers make well-informed decisions about which hospitals to use. A number of the quality measures that underpin the ratings unfairly impact teaching hospitals that treat low socioeconomic status patients, more complex patients, and perform a greater number of complicated surgeries. MedPAC, the National Quality Forum, and other researchers have underscored the importance of appropriately adjusting for socioeconomic status and patient complexity; and CMS has recognized the need for this adjustment in the Medicare Advantage and Medicare Part D programs. We also encourage CMS to incorporate the Office of the Assistant Secretary for Planning and Evaluation’s forthcoming findings on the impact of socioeconomic status on quality measures into future star ratings.
Additionally, we are concerned that CMS has provided insufficient details regarding the methodology used to determine these star ratings and has not provided hospitals with the data used to derive the ratings. We have heard from hospitals in our districts that they do not have the necessary data to replicate or evaluate CMS’s work to ensure that the methodology is accurate or fair. We believe that additional time is necessary for hospitals and stakeholders to thoroughly review the data and understand the impact of the current methodology to ensure the validity and accuracy of the information before it is publicly released. We respectfully request that you delay release of the star ratings to provide the necessary time to more closely examine the star rating methodology, analyze its impact on different types of hospitals, and provide more transparent information regarding the calculation of the ratings to determine accuracy.
We want to work together to ensure that hospitals are not penalized for treating the most vulnerable or complex patients in the star ratings system, the Hospital Readmissions Reduction Program, or any other quality program. We urge CMS to work with Congress and the hospital community to resolve these concerns. Thank you for your consideration of this request. We look forward to your response.
Sincerely,