How many stars did your hospital get? New federal hospital rankings released

Only one metro-east hospital received the top rating from a new federal hospital ranking system, but healthcare providers say the scores might be too simplified.

St. Joseph’s Hospital in Breese received the top rating from the Centers for Medicare & Medicaid Services, which released the new ratings system late last month. CMS ranked 4,000 Medicare-certified hospitals on a scale of one to five stars.

Most hospitals in the metro-east received three stars. Two metro-east hospitals received a four-star rating — Memorial Hospital in Belleville and St. Joseph’s Hospital in Highland — and three local hospitals got a two-star rating: Gateway Regional Medical Center in Granite City, Touchette Regional Hospital and St. Elizabeth’s Hospital in Belleville.

“We are excited the Centers for Medicare and Medicaid Services is looking for ways to inform consumers. We think that’s a good thing,” said Peggy Sebastian, CEO of St. Elizabeth’s Hospital in Belleville. “They maybe have oversimplified the process ... I think their attempt is laudable.”

CMS looked at 64 criteria reflecting only common conditions the hospitals treat. Also, hospitals were judged only by the information they provided. This might include as few as 9 or as many as 64 measures, according to the CMS’ website. The average was about 40 measures. Hospitals that perform more complex services or procedures are not reflected in the new ranking system.

Jim Dover said CMS is on the “right track” to helping Medicare and Medicaid patients make informed decisions. Dover is the president and CEO of the Southern Illinois Division of the Hospitals Sisters Health System, which owns and operates several metro-east hospitals including St. Elizabeth’s, St. Joseph’s in Highland, St. Joseph’s in Breese and Greenville Regional Hospital.

“It’s not a perfect measure,” he said of the CMS rating. “It’s the right start.”

Data used to determine rating

Hospital officials at both St. Elizabeth’s and Memorial say their hospitals submitted as much data as they possibly could.

“We believe in full transparency,” Dover said. “We believe in submitting anything we can.”

However, the data used to determine a hospital’s star rating is at least a year old.

“It’s a snapshot in time,” Dover said of the ratings. “Some (of the data) goes back as far as 2012.”

The Illinois Health and Hospital Association and some other state organizations are working with CMS to try to get more timely data, according to Sebastian.

For example, Dover said, in 2015, St. Joseph’s in Highland had no sepsis deaths thanks to a new approach toward treating the problem; however, that’s not reflected in the CMS star rating. Sepsis is a potentially life-threatening complication of an infection, according to the Mayo Clinic.

“They have 100 percent compliance for sepsis protocol,” Dover said. “It’s truly the best practice in the entire nation.”

Moving forward, Dover said HSHS is looking to standardized best practices across its hospital system, and it’s rolling out its sepsis protocol to all its hospitals. “We are moving toward far more consistencies between ministries,” he said, “and bringing the medical staff from those communities together and being more consistent.”

Some measures beyond hospitals’ control

In addition to hospitals’ concerns over what they considered old data, some representatives were also interested in how some health measurements were out of their control.

Kerry Wrigley, the director of quality improvement at Memorial Hospital, echoed concerns about oversimplification and a lack of timely data, but she said she “supports and confirms” the level of care where she works. Still, she questioned whether some of the information included in the score should be revisited.

A lot of the information consists of “outcome measures,” she said, which looks at patients’ health after they are released, Wrigley explained. When they’re out of the hospital, that naturally makes it more difficult for the hospital to track and care for their health.

In addition, a lot of the data submitted is grounded in Medicare claims data, which monitors older people and not a general population, which would give a better reflection of the Memorial’s population, Wrigley said.

Dover with HSHS would like the CMS rating to more closely examine readmission rates and include a patient’s socioeconomic status, which impacts readmission rates. Hospitals are penalized if a patient is readmitted to the hospital within 30 days, according to Dover.

“It takes in no account of socioeconomic factors,” he said. “We believe readmission is an important thing to look at. Personally, I would love to see it socioeconomically adjusted.”

One tool for consumers

Both Wrigley and Sebastian thought the new ranking system should be just one of many tools a patient should use when making decisions on quality healthcare.

“There are many different ratings we look at to aspire to assure we are serving our patients and their families,” Sebastian said. “It aspires us to serve our patients and excel at quality.”

Memorial referenced its patient safety award from Healthgrades, a private company that collects hospital data, that it earned for the past two years.

Dover said there are also other rating systems out there from outside agencies, including from The Leapfrog Group, which awarded St. Elizabeth’s an ‘A’ for patient safety.

“If you put a CMS star rating of two next to a Truven top 50 cardiovascular hospital, which are we? The answer is we are both,” Dover said. “ It’s like anything else you want to look at multiple, multiple inputs of information so patients can make really good choices.”

Sebastian encourages people to stay connected with their primary care physicians. “We feel the physician knows of all these programs, knows how to synthesize where the best services are based on the patient’s individual needs.”

Wrigley also recommended that patients talk with their doctors, friends and family. “Physicians know hospital care,” she said.

She mentioned that the new Memorial Hospital East in Shiloh, which opened in April, started collecting data July 1, but it will be another year before CMS assigns an initial rating to the hospital.

“We’ll have an eye on that data before it gets released,” Wrigley said.

This story was originally published August 14, 2016 at 7:12 AM with the headline "How many stars did your hospital get? New federal hospital rankings released."