The federal government released its first overall hospital quality rating on Wednesday, slapping average or below average scores on many of the nation’s best-known hospitals while awarding top scores to many unheralded ones.
The Centers for Medicare & Medicaid Services rated 3,617 hospitals on a one- to five-star scale, angering the hospital industry, which has been pressing the Obama administration and Congress to block the ratings. Hospitals argue the ratings will make places that treat the toughest cases look bad, but Medicare has held firm, saying that consumers need a simple way to objectively gauge quality.
Just 102 hospitals received the top rating of five stars, and few are those considered as the nation’s best by private ratings sources such as U.S. News & World Report or viewed as the most elite within the medical profession.
Medicare awarded five stars to relatively obscure hospitals and a notable number of hospitals that specialized in just a few types of surgery, such as knee replacements. There were more five-star hospitals in Lincoln, Nebraska, and La Jolla, California, than in New York City or Boston. Memorial Hermann Hospital System in Houston and Mayo Clinic in Rochester, Minnesota, were two of the only nationally known hospitals getting five stars.
Medicare awarded the lowest rating of one star to 129 hospitals. Five hospitals in Washington, D.C., received just one star, including George Washington University Hospital and Georgetown University Hospital, both of which teach medical residents. Nine hospitals in Brooklyn, four hospitals in Las Vegas and three hospitals in Miami received only one star.
Some premiere medical centers received the second highest rating of four stars, including Stanford Health Care in California, Massachusetts General Hospital in Boston, Duke University Hospital in Durham, North Carolina, New York-Presbyterian Hospital and NYU Langone Medical Center in Manhattan, the Cleveland Clinic in Ohio, and Penn Presbyterian Medical Center in Philadelphia. In total, 927 hospitals received four stars.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Medicare gave its below average score of two-star ratings to 707 hospitals. They included the University of Virginia Medical Center in Charlottesville, Beth Israel Medical Center in Manhattan, North Shore University Hospital (now known as Northwell Health) in Manhasset, New York, Barnes-Jewish Hospital in St. Louis, Tufts Medical Center in Boston and Washington Hospital Center in D.C. Geisinger Medical Center in Danville, Pennsylvania, which is a favorite example for national health policy experts of a quality hospital, also received two stars.
Nearly half the hospitals — 1,752 — received an average rating of three stars. Another 1,042 hospitals were not rated, including all hospitals in Maryland.
Medicare based the star ratings on 64 individual measures that are published on its Hospital Compare website, including death and infection rates and patient reviews. Medicare noted that specialized and “cutting-edge care,” such as the latest techniques to battle cancer, are not reflected in the ratings.
The government said in a statement that it has been using the same type of rating system for other medical facilities, such as nursing homes and dialysis centers, and found them useful to consumers and patients. Those ratings have shown, Medicare said, “that publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries.”
In a statement, Rick Pollack, president of the American Hospital Association, called the new ratings confusing for patients and families. “Healthcare consumers making critical decisions about their care cannot be expected to rely on a rating system that raises far more questions than answers,” he said. “We are especially troubled that the current ratings scheme unfairly penalizes teaching hospitals and those serving higher numbers of the poor.”
A preliminary analysis Medicare released last week found hospitals that treated large numbers of low-income patients tended to do worse, as did teaching hospitals.
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