Increased pressure for transparency and lower costs has created a wealth of hospital quality “report cards,” intended for consumers to make well-informed healthcare decisions. But as there are more and more of these ratings systems developed, instead of having a clear idea of quality of care, the waters get muddied. Imagine receiving five or more different report cards in school!

The Centers for Medicare and Medicaid Services (CMS) just released its attempt at a report card – a star rating system for hospitals – for the first time July 28. The system compresses all 64 quality measurements that make up the Hospital Compare database into a one-star through five-star ranking of hospitals around the country. The government’s hope was to provide a clear picture of hospital performance, but we think consumers will walk away from the new system more confused than before.

The New Jersey Hospital Association, its members and members of the New Jersey Congressional delegation were among many voices asking CMS to delay the release of the star ratings system until several issues were clear. We had concerns that the rankings were not adjusted for sociodemographic factors – a major driver of health outcomes – which punishes hospitals in ethnically diverse states like New Jersey. In New Jersey, there are more than 150 different languages spoken by our patients. This report card actually punishes hospitals that treat a large number of low income patients.

We were also concerned that, while the ratings were intended to increase transparency, hospitals were unable to get the data used by CMS to create the rankings. Not being able to replicate the process and double check the numbers used means hospitals have little recourse to dispute a potentially incorrect score. Other issues raised by hospitals and Congressional leaders included lower ratings for hospitals that see a disproportionate share of low-income patients and that train medical students.

Our members are not opposed to transparency. We tried to work with CMS to refine the process and create a useful tool for patients and their families across the state. An informed consumer is good for all parties involved. Unfortunately, the star system was published without many of the stakeholders’ concerns being addressed.

We will continue to work with CMS and other rating organizations to ensure that the high quality of healthcare offered in this state is recognized fairly and accurately.