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11 May

Five-star hospitals?

CMS five-star hospital ratings

In April 2015, the Center for Medicare and Medicaid Services (CMS) unveiled their new five-star quality rating on the Hospital Compare website which are based on the 11 publicly reported measures in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The intention is to make understanding the data easier for healthcare consumers.

Is it just me or does this start to feel more and more like a retail shopping experience? But here’s the deal – whether a point scale or star rating – it is driven by the healthcare consumer’s perception of the care they receive. I believe that understanding the emotion of the elusive consumer perception is why healthcare leadership is struggling with improving their CMS rankings. To support this point, let’s take a look at what different hospitals are trying:

  • Reducing ER wait times - You’ve seen the bill boards in your area advertising in real time the current average wait time in the locale Emergency Department. In today’s fast-paced world, we measure our impatience in Nano-seconds.  Faster is better – the more I wait the more impatient and dissatisfied I become as a consumer.  We should be careful with this demand as healthcare consumers because faster does not always equal better.


  • Employee pre-screening behavioral test – If I can determine your quotient for compassion towards others as a caregiver then your behavior while delivering care will translate to higher scores through improved perceptions – right? Get it? Happy employees = happy patients. I have actually seen this work in the service side of healthcare.  Screening for a high motivation and strong desire to care for the needs of others directly correlated to reduced staff turnover and improved morale.


  • Role playing for medical and non-medical interactions with patients and families - Helping the care team deal with conflicts in the patient room effectively can redirect the energy to more positive outcomes.


  • Getting to know patients on a personal level - Getting to know more about your hobbies, pets, kids, grandkids - sends a soft message that the care team member has time to address your needs as a patient.  This can be challenging to balance with today’s hectic pace in hospitals.


  • Hospital size:  smaller = more personal? - There is a perception that smaller hospitals are less hectic and that care teams have more time for patients. Hospital infrastructure will not change quickly – so if you subscribe to “smaller is more personal” – then larger hospitals will have to discover ways to deliver a “small hospital feel” by finding more time for their patients.  


All of the above are initiatives underway at various hospitals today and all are indirectly related to the actual medical care provided.  All can make contributions to the CMS five-star rating if executed properly and possibly improve the reimbursement received by the hospital and all are directed towards improving the patient’s experience and perception of the care they received. None directly impact the improvement of the actual medical care provided. Interesting right?

What do you think -- Is the five-star rating a step in the right direction or is it still missing the mark?

For more information on the CMS five-star quality rating, go to or here for the technical side of the star rating. To find the ratings for hospitals near you, go to the Hospital Compare website.



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