Crain’s Health Pulse
July 28, 2016
New York City hospitals fared far worse than their peers nationwide in a new five-star quality rating system released Wednesday by the Centers for Medicare and Medicaid Services that aims to help consumers choose facilities.
Of the 70 New York City area hospitals that received ratings, 54 earned either one or two stars. The skewed distribution differed from the national curve, which placed most hospitals in the middle of the five-star spectrum. Only 22.5% of U.S. hospitals earned one or two stars, according to data released by CMS ahead of the individual hospitals' scores.
The scores take into account as many as 64 different quality measures across the following categories: mortality, safety of care, readmissions, patient experience, effectiveness of care, timeliness of care, and efficient use of medical imaging.
Crain's compiled the ratings for hospitals in New York City, Long Island and Westchester online here.
Local and national trade groups had lobbied CMS to delay the release of the ratings, which they said were misleading to consumers because they didn’t account for patients’ socioeconomic status and the complexity of care provided.
“The sort of people we see at Montefiore and the type of care we have to provide them is vastly different than at other hospitals,” said Kate Rose, Montefiore’s vice president of government and community relations. “That isn’t accounted for in the stars.”
Montefiore’s facilities in the Bronx, New Rochelle and Mount Vernon all received two stars.
CMS defended the release as necessary to help consumers.
“We have received numerous letters from national patient and consumer advocacy groups supporting the release of these ratings because it improves the transparency and accessibility of hospital quality information,” the agency said.
It wasn’t all bad news for area hospitals. The Hospital for Special Surgery was the lone five-star recipient. But HSS chief executive Louis Shapiro said the orthopedic hospital wouldn’t be promoting its standing to patients.
“There’s a lot of controversy on the adequacy of the methodology, so we don’t plan on promoting our star rating,” he said. “Our focus is on making sure that we communicate completely and effectively what HSS’s unique value proposition is to everyone that matters—consumers, insurance companies, government and employers.”
Four local hospitals earned four stars: New York-Presbyterian Hospital and NYU Langone Medical Center in Manhattan; Northern Westchester Hospital in Mount Kisco, N.Y.; and John T. Mather Memorial Hospital in Port Jefferson, L.I.
NYC Health + Hospitals’ facilities didn’t fare as well, with the safety-net system’s 11 hospitals garnering three two-star ratings, and eight single-star grades.
Montefiore’s Rose was part of a coalition of providers urging CMS to alter its methodology. She argued that the readmissions component of the grade doesn’t factor in patients’ socioeconomic status.
She also said she believed CMS doesn’t weight hospitals’ risk-adjusted mortality rates heavily enough and inappropriately tries to compare all hospitals, despite differences in the types of procedures they might perform.
“When a consumer is shopping for where to get the best care in the country, I don’t doubt that a large number of them look to New York for the best doctors and best hospitals in the country,” she said. “That to me suggests something is not right."
The Greater New York Hospital Association said in a letter to members yesterday that low-volume hospitals had results for mortality, complications and readmissions that were replaced with numbers close to the national average.
“The results for these hospitals do not represent their actual quality,” GNYHA president Kenneth Raske wrote.