The American Hospital Association, the Association of American Medical Colleges, America's Essential Hospitals and the Federation of American Hospitals sent a letter Thursday to CMS, insisting the agency further delay the release of its overall star ratings until issues are addressed.
The overall star ratings for hospitals were supposed to be released in April, but CMS pushed the launch back to July after stakeholders protested the stars' methodology.
In the new, four-page letter addressed to Patrick Conway, MD, CMS' deputy administrator for innovation and quality, the organizations say they are "deeply disappointed" that CMS has not worked with them on the "serious concerns" they have with the program's methodology.
According to the letter, CMS has not shown the validity of its method of assigning star ratings to hospitals based on quality metrics like readmissions, mortality, effectiveness and timeliness of care, and patient experience scores.
The organizations ask Dr. Conway to share more information about how the star ratings reflect hospital performance and address "significant underlying methodological problems" with the ratings system.
Major problems outlined in the letter include:
- Failure to incorporate patients' socioeconomic factors into quality metrics
- The "large difference in the number of measures comprising a star rating for smaller…hospitals versus the number used to assess larger, multispecialty hospitals"
- The arbitrary assignment of weights to measures or groups of measures
"Until CMS has taken the time to address these problems and share information with hospitals and the public demonstrating that its star ratings methods offer a fair and accurate assessment of hospital quality, we strongly urge the agency to continue to withhold publication of the flawed star ratings," the letter reads.
The groups also attached an analysis of the program done by a Georgetown University economist, which found the CMS methodology to have "several shortcomings."