CMS Hospital Compare: Patient Experience Translated Into Stars

Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide care to their patients. It allows consumers to select multiple hospitals and directly compare performance measure information related to heart attack, heart failure, pneumonia, surgery and other conditions.

What Is HCAHPS?

The HCAHPS - pronounced "H-CAPS" - (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey is a standardized questionnaire that measures patient perspectives of hospital care. HCAHPS results posted on Hospital Compare provide ratings, including comparisons to state and national averages, that help consumers understand how hospitals perform.

HCAHPS Star Ratings

On April 16, 2015, the Centers for Medicare & Medicaid Services (CMS) added HCAHPS Star Ratings to the Hospital Compare website as part of the initiative to add 5-star quality ratings to its Compare websites. CMS believes that star ratings spotlight excellence in health care quality and make it easier for consumers to use the information on the Compare websites. The ratings also support using quality measures as a key driver of health care system improvement.

Twelve HCAHPS Star Ratings appear on Hospital Compare: one for each of the 11 publicly reported HCAHPS measures, plus the new HCAHPS Summary Star Rating. HCAHPS Star Ratings are the first star ratings to appear on Hospital Compare and CMS plans to update the HCAHPS Star Ratings each quarter.

HCAHPS Measures Used to Determine Star Ratings

There is a star rating for each of the following HCAHPS measures:

• HCAHPS Composites Measures
  • Communication with Nurses (Q1, Q2, Q3) 
  • Communication with Doctors (Q5, Q6, Q7) 
  • Responsiveness of Hospital Staff (Q4, Q11) 
  • Pain Management (Q13, Q14) 
  • Communication about Medicines (Q16, Q17) 
  • Discharge Information (Q19, Q20) 
  • Care Transition (Q23, Q24, Q25) 
• HCAHPS Individual Items
  • Cleanliness of Hospital Environment (Q8)
  • Quietness of Hospital Environment (Q9) 
• HCAHPS Global Items
  • Overall Hospital Rating (Q21) 
  • Recommend the Hospital (Q22)

Other "Compares" with Stars

CMS already uses star ratings in other Compare websites:

• Nursing Home Compare 
• Physician Compare
• Dialysis Facility Compare
• Home Health Compare (stars coming later this year)
• Medicare Plan Finder uses star ratings to help beneficiaries select parts C and D plans. These star ratings also determine quality bonus payments for plans.

Why Can't I Find My Hospital?

All hospitals that participate in the HCAHPS Survey are eligible to receive HCAHPS Star Ratings, which includes both Inpatient Prospective Payment System (IPPS) hospitals and Critical Access Hospitals (CAH). IPPS hospitals are required to report HCAHPS as part of the Hospital Inpatient Quality Reporting (IQR) Program and CAHs voluntarily participate. 

In addition, hospitals must have at least 100 completed surveys in the 12-month reporting period and be eligible for public reporting in order to receive HCAHPS Star Ratings.

Exploring Hospital Compare

If you or a loved one has had a hospital experience recently, go to Hospital Compare and see if your experience correlates with other patient feedback. Please share your comparison in the comments!

Photo Credit: Carol Green via Compfight cc

Mary Pat Whaley is a Physician Advocate and Consultant who blogs at Manage My Practice. Her LinkedIn group of the same name, Manage My Practice, is for those interested in healthcare management.