Tag: Hospital Consumer Assessment of Healthcare Providers and Systems Survey

Improving HCAHPS Star Ratings: Insights From the Ascom HCAHPS Database

By Chris Talbot, senior vice president of marketing and business development, Ascom.

Chris Talbot

More than 4,900 U.S. hospitals participate in the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS), including 3,529 that received star ratings in the most recent quarterly update. These ratings reflect an effort by the Centers for Medicare & Medicaid Services (CMS) to help consumers make informed choices about their care, putting more decision-making and purchasing power in their hands.

Because star ratings are expected to play an increasing role in helping consumers choose hospitals, it is important to understand these metrics and what hospitals can do to improve their performance.

Toward that end, Ascom created a comprehensive, time series database of hospital HCAHPS performance.

Changes to hospital Star Ratings over time

Leveraging our database, we conducted a year-over-year analysis of star ratings for all participating hospitals, providing insights into how star ratings change over time as well as clues to what it may take to improve performance.

As shown in the table below, our analysis revealed that star ratings tend to be sticky. In our year-over- year comparison across all hospitals, 61 percent of ratings remained unchanged. Overall, only 18 percent of ratings improved over a 12-month period, while 21 percent declined.

Why Star Ratings are slow to change

There are two main reasons that hospitals’ star ratings tended not to change over a 12-month period.

  1. Because the quarterly HCAHPS results include four quarters’ worth of survey data, it can take a while for improvements to show up in the ratings. Even if a hospital achieves significant improvements in its most recent quarter, that quarter’s results are combined with the previous three quarters’ poorer results when they are reported by CMS.
  2. There is also the difficulty of the task at hand. It’s not just a matter of providing excellent patient care – which is difficult enough; it’s also a matter of providing this level of care at the highest level of consistency.

Consistency is the key to improvement

Consistency is important at two levels. The first is across the HCAHPS domains. While HCAHPS monitors several different individual domains such as care transition, cleanliness, etc., they all add up to a total experience across each individual patient’s journey.

Our correlation analysis between all the linear mean scores for all HCAHPS domains found that if a patient’s satisfaction with one domain was high, then satisfaction with all domains tended to be high and vice versa. This in turn drove overall satisfaction with the hospital, and patient likelihood to recommend the hospital to others.

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CMS Releases First Ever Hospital Compare Star Ratings

The Centers for Medicare & Medicaid Services (CMS) for the first time introduced star ratings on Hospital Compare, the agency’s public information website, to make it easier for consumers to choose a hospital and understand the quality of care they deliver. According to the organization, “This announcement builds on a larger effort across HHS to build a healthcare system that delivers better care, spends healthcare dollars more wisely, and results in healthier people.”

The Hospital Compare star ratings relate to patients’ experience of care at almost 3,500 Medicare-certified acute care hospitals. The ratings are based on data from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) measures that are included in Hospital Compare. HCAHPS has been in use since 2006 to measure patients’ perspectives of hospital care, and includes topics like:

“The patient experience Star Ratings will make it easier for consumers to use the information on the Hospital Compare website and spotlight excellence in health care quality,” said Dr. Patrick Conway, acting principal deputy administrator for CMS and deputy administrator for Innovation and Quality. “These star ratings also encourage hospitals and clinicians to strive to continuously improve the patient experience and quality of care delivered to all patients.”

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