CMS hospital ratings show performance decline in 2024

Editor's Note

Hospital performance declined this year compared to last, with more than 60% earning three stars or less in 2024 hospital star ratings from The Centers for Medicare and Medicaid Services (CMS).

“This decline might be partly due to the data covering the period from April 2019 to March 2023, which excluded the first half of 2020 when the pandemic began,” Modern Healthcare reported August 1. According to that article, other key takeaways from the ratings include:

• Increase in one-star ratings: Nearly 10% of the 2,834 hospitals rated by CMS received one star, marking an increase of about 30 facilities compared to 2023. Additionally, there were 100 fewer five-star ratings. Critical access hospitals and acute care facilities had notably fewer five-star ratings, while Veterans Administration hospitals saw an increase from 32% to 35%.
• Fewer rated hospitals: This year, 227 fewer hospitals were rated. This reduction is partly because some hospitals could not report enough measures for a rating, especially critical access hospitals with lower patient volumes. Some facilities may have opted out of the ratings altogether, as participation is not mandatory for critical access hospitals.
• Consistency in ratings: About 51% of hospitals maintained the same star rating as in 2023. The lack of changes in CMS’s scoring methodology contributed to this stability. However, some large hospitals experienced a drop in their ratings by two or three stars.
• Pandemic impact: Despite efforts to improve patient care and experience, the star ratings remain negatively affected by the pandemic. The ratings used data from various pandemic phases, highlighting ongoing challenges such as financial struggles, staffing issues, and high patient acuity.

Push for health equity adjustment: Industry trade groups are advocating for CMS to include social risk factors in their star ratings. This adjustment would ensure consideration of hospitals in marginalized communities that face challenges like homelessness, disability, and lack of access to care. CMS’s Hospital Value-Based Purchasing Program already includes a health equity adjustment that accounts for both quality performance and social health drivers.