The federal government released its first overall hospital quality rating last week, giving average or below average scores on many of the nation’s best-known hospitals while awarding top scores to dozens of unheralded ones. The Centers for Medicare & Medicaid Services rated 3,617 hospitals on a one- to five-star scale, angering the hospital industry, which has been pressing the Obama administration and Congress to block the ratings. Hospitals argue the ratings will make places that treat the toughest cases look bad, but Medicare has held firm, saying that consumers need a simple way to objectively gauge quality. Medicare does factor in the health of patients when comparing hospitals, though not as much as some hospitals would like.
Just 102 hospitals received the top rating of five stars, and few are those considered as the nation’s best by private ratings sources such as U.S. News & World Report or viewed as the most elite within the medical profession. Medicare awarded five stars to relatively obscure hospitals and at least 40 hospitals that specialize in just a few types of surgery, such as knee replacements. There were more five-star hospitals in Lincoln, Neb., and La Jolla, Calif., than in New York City or Boston. Five hospitals in Washington, D.C., received just one star, including George Washington University Hospital and MedStar Georgetown University Hospital, both of which teach medical residents.
A preliminary analysis of Medicare’s study found hospitals that treated large numbers of low-income patients tended to do worse. Medicare does not consider patients’ social and financial situations in rating hospitals. For example, Cooper University Hospital in Camden, NJ received two stars, while Virtua Hospital in Voorhees, NJ received four stars. Critics of Medicare’s hospital ratings consider the rating system flawed due to the failure to account for patients’ social and financial status.