Modern Healthcare December 5, 2018
Maria Castellucci

Hospitals with a high percentage of dual-eligible stays do worse than other hospitals in the readmissions category of the CMS star ratings, hurting their overall star rating, according to a Modern Healthcare analysis of CMS data.

In the latest preview of the CMS star ratings that will be released on Hospital Compare in February, the agency didn’t risk-adjust hospitals by peer groups based on their dual-eligible population as it currently does in the Hospital Readmissions Reduction Program. As a result, hospitals in peer groups four and five of that program—or those with the largest percentage of dual-eligible stays—fared worse on average than other hospitals in the readmissions category of the star ratings, an analysis of the data by...

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Topics: CMS, Equity/SDOH, Govt Agencies, Health System / Hospital, Insurance, Medicare, Patient / Consumer, Payment Models, Physician, Provider, Value Based
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