The CMS five-star quality rating system is a measure of the experiences Medicare beneficiaries have with their health plan and health care system rated on a scale of 1 to 5 stars, with 5 being the highest quality.
The Star ratings are generated by CMS with patients and their families as the intended consumer. The overall rating is generated based on the results from inspections, scores on quality metrics, and staffing ratios. It is a widely used indicator of the quality of a facility. By bringing it into the product we make the evaluation of competitors more efficient by reducing the need for our customers to find the star rating in the publicly available files. For more information on Star ratings see the CMS pages for Home Health, Hospitals, and Nursing Homes.
Star ratings will only be found on medical facilities. Physicians do not have star ratings.
Facility Star Rating Not Available?
Some facilities will not have a star rating. The common causes are:
- Star Ratings are attached to the CMS Certification Number (CCN) and sometimes the CNN doesn’t map to the NPI. This is almost always because the NPI is a “sub-NPI” or hospital unit. In this case the data actually is reported on the primary NPI for the facility.
- Facility may have inpatient claim types but it is not a General Acute Care Hospital. Examples: Psychiatric Facilities, Long-Term Acute Care, certain Rehabilitation Facilities, etc.
- The hospital has too few reported cases to CMS and as such are exempt from that publicly reported data
When do we update Star Ratings?
Each time CMS releases new Star ratings, we add them to Marketscape at our next data release. This means that there will be short periods where Marketscape will lag behind the latest ratings. Since we have monthly data releases, in addition to our quarterly releases of new datasets, this lag will always be no more than about a month behind.
If you are interested in the latest ratings published by CMS click the links below.
Article is closed for comments.