How Many Stars For Your Hospital? The Pros And Cons Of New Medicare Hospital Ratings

The federal government is out with a five-star rating system for the hospital near you and more than 3,600 across the country.

In Massachusetts, half of the hospitals earned three stars. Only one scored the top five-star rating and there is only one with a single star. (See the full Massachusetts list at the bottom of this post.)

The rating is based on 64 measures including patient-reported hospital cleanliness, infection rates, how often Medicare patients are readmitted for heart failure and how often those with pneumonia die.

Many hospitals are not pleased with the new practice.

"As presented today, we think it’s too flawed to be reliable," said Tim Gens, executive vice president of the Massachusetts Hospital Association.

"The system does not reflect the reality of patients, the type of patient a hospital takes. It doesn’t factor in the socio-economic differences and those mistakes in methodology make big differences among hospitals," Gens said.

The Centers for Medicare and Medicaid Services (CMS) says it did factor those differences into some of the measures, but, Gens says, not enough.

Other hospital executives say the ratings may be misleading because they are based on things like readmissions or infection rates, when experts are still tweaking those quality measures. Dr. Elizabeth Mort, senior vice president for quality and safety at Massachusetts General Hospital — given four stars — says the ratings aren’t ready for publication.

"They’re really not strong enough measures to assign a quality ranking and differentiate one hospital from another, to drive decisions about which one to go to," she said.

Mort says there may not be much difference between hospitals in the middle, between a two- or three-star hospital or between those with three or four stars. All but two hospitals in Massachusetts are in the two to four star range. New England Baptist is the only hospital in Massachusetts that earned five stars.  UMass Memorial Medical Center has just one.

“While we do not agree with the CMS hospital star ratings designation for our hospital, we do support the important, ongoing national effort to increase hospital transparency," said UMass Memorial spokesman Anthony Berry in an emailed statement. "Our goal at UMass Memorial is to be the best place to give care and the best place to get care. We recognize that we are not quite there yet and focus daily on ways to improve the experience for our patients."

Consumer groups, including Health Care For All (HCFA), applaud the federal CMS for shedding light on differences between hospitals.

"A five-star rating system may be a blunt instrument, but it’s absolutely a step in the right direction so that hospitals can compare themselves to their colleagues across the state and so that patients can make the best possible choice for their inpatient care," HCFA director Amy Whitcomb Slemmer said.

CMS says it will update the star ratings quarterly.

-- Here's a table of all the Massachusetts hospital ratings: