Rating the Raters: An Evaluation of Publicly Reported Hospital Quality Rating Systems

NEJM August 14, 2019
Karl Y. Bilimoria, MD, MS, John D. Birkmeyer, MD, Helen Burstin, MD, MPH, Justin B. Dimick, MD, MPH, Karen E. Joynt Maddox, MD, MPH, Allison R. Dahlke, MPH, John Oliver DeLancey, MD, MPH & Peter J. Pronovost, MD, PhD

Introduction

The numerous currently available public hospital quality rating systems frequently offer conflicting results, which may mislead stakeholders relying on the ratings to identify top-performing hospitals. Given that there is no gold standard for how a rating system should be constructed or perform and no objective way to compare the rating systems, we evaluated the strengths and weaknesses of four major public hospital quality rating systems based on our experience as physician scientists with methodological expertise in health care quality measurement.

No rating system received an A or an F. The highest grade received was a B by U.S. News & World Report. The Centers for Medicare and Medicaid Services’ (CMS) Star Ratings received a C. The lowest grades were...

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