Hospitals submit their own data and become eligible to receive a rating when they report at least three measures in each of three or more measure groups, including either mortality or safety of care.
CMS Hospital Quality Star Ratings are important not only in terms of care quality measurement, but they also affect payments under the Hospital Value-Based Purchasing (VBP) Program that includes quality measures in these four categories: clinical outcomes, safety, person and community engagement, and efficiency and cost reduction.
Many of the CMS Hospital Quality Star Ratings measures overlap with those in the Hospital VBP Program. When an organization strives to improve its star ratings, its benefits are twofold: It paints an accurate picture of the quality of care it’s providing, and it also boosts payment under VBP programs. Success in both categories is crucial to survival in today’s increasingly competitive market to attract patients and become the leading provider of choice in the market.
Leveraging data to drive performance improvement
Publicly-reported outcomes data is driven directly by the medical codes a healthcare organization assigns for patient safety indicators (PSI), hospital-acquired conditions (HAC), healthcare-associated infections (HAI), and more. If the codes aren’t accurate or complete, the outcomes data will be flawed as well, and revenue will be negatively impacted.