Healthgrades’ 2024 specialty hospital ratings suggest that improving hospital quality across the board could reduce U.S. mortality and complication rates. If all hospitals matched the quality of five-star hospitals, an estimated 215,667 lives and 149,521 complications could be saved. However, hospital rating systems, like Healthgrades and CMS, face challenges in accurately conveying complex quality data, and some hospitals, particularly smaller ones, struggle to meet these standards. Recent research highlights the need for more nuanced assessments to better reflect hospital quality.
Healthgrades recently unveiled its specialty hospital rankings, highlighting the potential decline in mortality and complication rates if all hospitals could match the quality of five-star hospitals. According to Healthgrades’ 2024 specialty hospital ratings release, the U.S. healthcare industry could witness substantial enhancements in patient safety measures, potentially preventing deaths and health complications.
In a level playing field, Healthgrades estimates that the U.S. healthcare sector could avoid 215,667 fatalities and 149,521 hospital complications if all hospitals achieved the standards set by five-star hospitals. This assessment, based on data spanning 2020 to 2022, underscores the stark performance differences between the top-rated specialty hospitals and their lower-rated counterparts.
For instance, a heart attack patient treated at a five-star hospital faces a 50 percent lower risk of in-hospital mortality compared to treatment at a one-star facility. Similarly, individuals undergoing total knee replacement at a five-star hospital have an 80 percent lower risk of complications compared to those treated in one-star hospitals.
Understanding hospital quality is a vital component of the patient care access process, as numerous studies have emphasized. Hospital quality is a major factor influencing patients’ choices, often outweighing factors like cost and convenience.
Healthgrades adopts a five-star rating system to help healthcare consumers grasp hospital quality across different organizations, akin to star ratings used in other industries. This approach aligns with other healthcare industry rankings, such as CMS Hospital Star Ratings and The Leapfrog Group’s letter grades.
The Healthgrades 2024 Specialty Excellence Awards and Five-Star Specialty Care Ratings examine 16 specialty care areas, including surgery, critical care, and orthopedic surgery, across approximately 4,500 hospitals. Hospitals in the top 5 or 10 percent for different specialty care areas receive the Specialty Excellence Award, and Healthgrades also recognizes the top 100 and top 50 hospitals for specialty care.
Notably, Healthgrades is among the select organizations that provide hospital ratings to assist healthcare consumers in making informed care access decisions. The Centers for Medicare and Medicaid Services (CMS) issues its own star ratings, particularly valuable for services that can be scheduled, such as joint replacements and elective surgeries.
In a July 2023 update of the CMS Hospital Star Ratings, the agency reported that 16 percent of the 3,076 healthcare organizations analyzed received the highest rating. About 26 percent secured a 4-star rating, while nearly 28 percent earned a 3-star rating, and just under 22 percent received a 2-star rating. A mere 8 percent of hospitals were rated with 1 star, often due to inadequate measures or reporting across various categories.
Approximately one-third of hospitals didn’t receive a star rating from CMS due to insufficient data submission or reporting in multiple categories, as the agency noted.
The Accuracy of Hospital Rating Systems:
Communicating healthcare quality to consumers can be a challenging task. Assessing healthcare quality involves numerous complex factors, ranging from clinical outcomes to risk adjustment. However, conveying these complexities in a manner that is easily comprehensible can be a challenge, according to some researchers.
Specifically, data has indicated that reducing hospital quality to a single five-star rating may oversimplify the assessment. For instance, in 2022, a KNG Health analysis, commissioned by the American Hospital Association, revealed that the CMS Hospital Star Rating methodology might not adequately account for the unique circumstances of small, rural, and critical access hospitals.
These smaller, often under-resourced hospitals may not have the capacity to report sufficient quality data to generate a reliable five-star rating. In a separate 2019 report published in the New England Journal of Medicine Catalyst, four hospital rating systems, including those of CMS and Healthgrades, were evaluated based on their potential for misclassifying hospital performance, relevance to patient populations, scientific acceptability, history of iterative improvement, transparency, and usability.
Overall, the researchers did not rate these ranking systems particularly highly. Some rating systems criticized the analysis for not accurately representing their methodologies. It’s worth noting that since this assessment, which took place over four years ago, rating systems may have updated their survey methodologies to better reflect hospital quality.
