Few U.S. hospitals attain five-star quality of care

Only 2.2 percent of U.S. hospitals earned a five-star quality rating from CMS in its Overall Hospital Quality Star Rating (Star Rating) system, which reflects the level of patient care received. According to a CMS data brief preview and evaluation, 934 hospitals, or 20.3 percent, received a four-star overall hospital quality star rating. The most common rating was three stars, which was received by 1,770 hospitals, or 38.5 percent. Two stars were given to another 723 hospitals, or 15.7 percent, and 133, or 2.9 percent, received only one star.

Notably, another 937 hospitals, or more than 20 percent, were not assigned a rating. No star rating is assigned to hospitals that do not report or do not have the requisite minimum amount of data, which can occur for small or new facilities.

CMS’ Star Rating takes 62 existing quality measures already reported on the Hospital Compare website and summarizes them into a unified rating of one to five stars. Quality measures range from the routine care an individual receives when being treated for heart attacks and pneumonia to quality measures that focus on hospital-acquired infections, such as catheter-associated urinary tract infections.


CMS believes that star ratings spotlight excellence in health care quality and make it easier for consumers to use the information on the Hospital Compare website (see Care to compare? Hospital five-star rating system now available, Health Law Daily, April 16, 2015). This is consistent with the call for transparent, easily understood, and widely available public reporting found in the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). The ratings also support using quality measures as a key driver of health care system improvement.

CMS had previously delayed its intended April 21, 2016, release of overall hospital quality star ratings on its Hospital Compare website until at least July 2016. The delay was partly attributable to efforts raising concerns about whether the involved methodology for star ratings provided a fair, accurate, and meaningful representation of hospital performance.

Lawmakers and associations, alike, noted that a number of the quality measures that are the ratings’ foundation impact teaching hospitals that treat patients of low socioeconomic status, treat more complex patients, and perform various complicated surgeries (see Lawmakers’, hospitals’ wish upon star ratings temporarily granted, Health Law Daily, April 21, 2016).