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On January 1, 2017, the KHI News Service became part of KCUR public radio’s new initiative, the Kansas News Service. The Kansas News Service will continue to cover health policy news and broaden its scope to include education and politics. All stories produced by the former KHI News Service are archived here. Stories and photos may be republished at no cost with proper attribution and a link back to KHI.org.

Five Kansas hospitals receive five stars in Medicare’s new ratings

By Dan Margolies, HEARTLAND HEALTH MONITOR | July 28, 2016

Five Kansas hospitals receive five stars in Medicare’s new ratings
Photo by Shawnee Mission Medical Center Shawnee Mission Medical Center received five stars in the hospital quality rankings released Wednesday by the Centers for Medicare and Medicaid Services. It was one of five Kansas hospitals that received the top rating.

Federal health officials Wednesday released much anticipated — and controversial — quality ratings for 4,000 hospitals in the United States, and five Kansas facilities received the top rating of five stars.

The ratings, published by the Centers for Medicare and Medicaid Services, are intended to enable consumers to comparison shop and to encourage hospitals to improve their quality of care.

The hospital industry has criticized the ratings system as overly simplistic and its methodology as flawed. And hospitals that serve largely poor populations or deal with more complex cases say it unfairly penalizes them.

CMS had planned to release the ratings earlier, but pressure from Congress and hospital groups delayed publication.

The star ratings provide a “snapshot” of Medicare-certified hospitals by summarizing up to 64 quality measures reflecting common conditions they treat.

The measures are grouped under seven broad categories:

  • Mortality, for example, the death rate for heart attack patients.
  • Safety of care, for example, central line-associated bloodstream infections.
  • Readmissions, for example, how likely patients are to get readmitted to the hospital after a heart attack.
  • Patients’ experiences based on their responses to surveys.
  • Effectiveness of care.
  • Timeliness of care.
  • Efficient use of medical imaging.

The ratings, which are based on data the hospitals report to CMS, have significant limitations. For one thing, some of the information is several years old.  

“I’ve used the analogy before that it’s very much like trying to drive by looking in the rear-view mirror,” said Dr. Tim Williamson, vice president of quality and safety at the University of Kansas Hospital, which received three stars.

Another limitation: Academic medical centers, like KU Hospital, and safety net institutions tend to have more complex patient populations than other hospitals, something the ratings don’t fully account for.

Williamson notes that KU Hospital’s population includes transplant patients, severely immunocompromised patients and patients who were too sick to be treated at other hospitals and were transferred to KU Hospital.

“For us, there’s fairly limited utility in guiding us in some way or, even more important, guiding the consumers in how to use this particular rating system,” he said.  

“I’m disappointed that (the rating) is not higher,” he said, “but at the same time I don’t think it really — there are so many flaws to it — I don’t think it accurately reflects the care we provide.”

Larry Botts, Shawnee Mission Medical Center’s chief medical officer, acknowledges the ratings have limitations but said the conditions and illnesses they reflect are among the most common hospitals encounter.

“It covers a lot of territory, which probably makes it a little more valid,” he said.

Botts said Shawnee Mission’s five-star rating validates the work his hospital has done to improve patient safety and quality of care.

“Most importantly, this is a continuing journey,” he said. “We have lots of opportunities, and so does everyone else, to improve, so our goal is to continue that quality and safety journey so we can continue to have that five-star rating.”

Just more than 2 percent of the hospitals surveyed, or 102 nationwide, received five-star ratings.

Shawnee Mission Medical Center was the only non-specialty hospital in Kansas to get that rating.

Three specialty hospitals in Wichita — Kansas Heart Hospital, Kansas Spine & Specialty Hospital and Kansas Surgery & Recovery Center — and Premier Surgical Institute in Galena also received five stars.

In advance of releasing the star ratings, CMS last week reported that the mean rating for safety net hospitals was 2.88 compared with 3.09 for non-safety net hospitals.

Teaching hospitals’ mean star rating was 2.87 compared with 3.11 for non-teaching hospitals.

— Dan Margolies is based at KCUR.