Much like advancements in technology have recently revealed previously unseen stars and galaxies, there is an opportunity in healthcare to bring additional stars to light. Virtual stars, that is, like the ones used in ratings for hospitals and insurance companies.
Star ratings were put into place by the Centers for Medicare and Medicaid Services (CMS) to help consumers compare hospitals and insurance providers and make informed choices about the quality of their healthcare. These ratings follow the familiar five-star format, with five stars equating to significantly above-average quality and one star meaning quality is below average.
The hospital quality star rating from CMS takes the average of a hospital’s score across five categories (with over 100 measures in each) for the overall rating. These categories include:
- Safety of care
- Patient experience
- Timely and effective care
The data for this rating system is typically collected from patients through surveys managed by third-party vendors. Healthcare organizations can also submit data points to be averaged into the score.
While the calculations are straightforward, understanding how to improve them can be more challenging. But it’s a challenge worth tackling when a higher star rating can mean better reimbursement opportunities and a stellar reputation with current and prospective patients and members.
Here are three steps to get you started:
Step #1: Create a clear path to your data.
Data that is easily accessible is data that gets used, particularly when it is needed for CMS to reimburse your facility for services rendered. If a star rating is low, it could put your organization in jeopardy of not getting reimbursed by a consumer’s healthcare insurance company or lead to even more serious issues such further auditing, fines, or being shut down. Of course, it’s also important to keep track of your patient or consumer perspective to see how they feel about the quality of care received. The combination of qualitative and quantitative data included in star ratings is crucial to get a read on consumer sentiment.