CMS Hospital Star Ratings: The Latest Updates
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CMS Hospital Star Ratings: The Latest Updates

By David Fetterolf, Stratus Video President

In response to recent feedback from a technical expert panel and public input period, the Overall Hospital Quality Star Rating has been updated to provide more transparency to stakeholders.

What It Is

The rating was put into effect by the Centers for Medicare & Medicaid Services (CMS) to enable patients and caregivers to more seamlessly compare hospitals and healthcare facilities. Hospitals are assessed across 64 quality measures to create an overall score on a scale of one to five stars. The assessment outcome is of great significance to hospitals, as the credibility, efficiency, culture and financial state of the institution are directly impacted by the star rating.

Facilities achieving higher scores tend to foster a more patient centered culture throughout the organization. It has also been shown that hospitals who place great emphasis on the importance of both patient satisfaction and quality of care earn the highest star ratings.

What Changed

In December of 2017, CMS implemented enhancements to the Overall Star Rating methodology in an effort to provide more transparent information to stakeholders. A public release detailing the updates implemented by the Centers of Medicare and Medicaid Services explains that the enhancement plan was developed in response to feedback provided by a technical expert panel and provider leadership work group of hospital associations and hospital executives as well as insight gained from a public input period. Methodological enhancements include the following:

  • Inclusion of both non-adaptive and adaptive quadrature in the latent variable model
  • Addition of multiple iterations of k-means clustering to achieve complete convergence
  • Elimination of the winsorization step for hospital summary score outliers
  • Assignment of the Star Rating after applying the public reporting threshold


In addition, CMS added and removed two measures to/from the Readmission and Effectiveness of Care groups.


  • Rate of unplanned hospital visits after an outpatient colonoscopy (OP-32)
  • Percentage of patients receiving appropriate radiation therapy for cancer that has spread to the bone (OP-33)



  • Thrombolytic Therapy (STK-4)
  • Venous Thromboembolism Warfarin Therapy Discharge Instructions (VTE-5)


Read the CMS public release for more information surrounding updates to the Overall Star Rating methodology.

What Changes Means for Hospitals and Health Systems

These updates were implemented following statistical analyses to provide more reliable hospital ratings. Changes in measure performance and the measures in the Star Rating influence the distribution of the rating results. A CMS table outlining star rating distributions prior to and following the implementation of the new methodology indicates a rise of more than 7% in the number of hospitals who achieved 5 stars.

How Hospitals Can Improve Ratings

High overall care quality is correlated with high patient satisfaction. By providing patient centric services, such as language services for the limited English proficiency (LEP) and Deaf and Hard of Hearing (HOH) patient population, hospitals can work towards improving patient satisfaction and quality of care. High star rating facilities foster a culture of constant progress towards improved patient care and care quality. There are several steps that facilities can take to improve ratings and foster such a culture, including

  • Enhancing focus on consumer perception,
  • Conducting regular data assessment,
  • Retraining healthcare staff and
  • Enabling better patient-provider communication.


Read our white paper Overall Hospital Star Rating Revealed: How to Improve Care Quality in Your Facility for more insight on how to improve your CMS ratings.

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