Health care facilities challenge ratings

HUDSON — The federal government released hospital ratings for the Capital Region and the results indicate there is room for improvement. Columbia Memorial Hospital in Hudson received a two-star rating, out of a possible five stars.

The ratings were released last week by the U.S. Centers for Medicare and Medicaid Services and measure several factors, including mortality rates, safety of care, readmission, patient experience, effectiveness of care, timeliness of care and efficient use of medical imaging.

The overall rating is a summary of quality measures based on commonly treated health conditions, according to the U.S. Centers for Medicare and Medicaid Services website.

Columbia Memorial received quality ratings that were below the national average, according to the report, in four of seven categories: safety of care, readmission, patient experience and timeliness of care. In the remaining categories, the hospital was ranked same as the national average.

The ratings system has been regarded as controversial among some in the health care industry who question the findings.

“Most of the health care industry, including CMH, has serious concerns about the accuracy and reliability of CMS’ star-rating system,” Columbia Memorial Hospital spokesman Bill Van Slyke said.

The hospital has made improvements in recent years, he added.

“CMH has made tremendous strides in patient safety and care quality over the last decade. Based on numerous surveys and patient feedback, we know that the community is aware of how much we have progressed, and that’s the measure that matters most to us,” Van Slyke said.

Loretta Willis, vice president of the Healthcare Association of New York State, which represents 500 health care organizations statewide, also questioned the findings and the ratings methodology.

“The star ratings have been in effect for a few years and from the beginning, the Healthcare Association and the American Hospital Association, among others, have spent a great deal of time doing a very detailed analysis of the methodology,” Willis said. “From the beginning, the methodology has been deemed flawed at best by several clinical and statistical experts.”

The method used to come up with the star ratings conflated several unrelated areas of care, she said. For instance, in one category that is measured, Willis said, the survey combines the measures patient safety and billing, which was originally designed to identify diagnoses for billing purposes.

“It was not meant to reflect quality and as a result of these disparate measures, CMS is attempting to come up with a composite rating that takes all these different approaches and tries to reduce it into something that will help the consumer,” Willis said. “Our membership and HANYS as a health care organization absolutely supports the consumer’s right to be in the know. Our issue is that star ratings in its current form is one of many report cards that are serving to confuse consumers because it is not a true reflection of quality in our facilities.”

The star ratings also do not take into account other variables, such as regional and demographic differences among health care facilities, age of population, ethnicity and other factors, Willis said.

Jack Mabb, public health director for the Columbia County Department of Health, said the ratings do not affect how his agency serves the community.

“Medicare hospital rating is not a direct factor to the services we provide,” Mabb said. “What needs to be done, or making any suggestion for improvements, really, is done by the institution being rated and not from the Columbia County Health Department.”

Albany Medical Center showed lagging ratings and received one star.

The hospital was rated “below the national average” in readmission, patient experience, effectiveness of care and timeliness of care.

Albany Medical Center spokeswoman Sue Ford also questioned the ratings and how they are determined, specifically with regard to comparing hospitals that provide different levels of care.

“As the region’s only academic medical center and level-one trauma center, Albany Med provides a unique level of care for many of the region’s most critically ill and injured patients,” Ford said. “Unfortunately, this measure, which has been criticized by quality experts and Congress as being inaccurate and misleading, compares very different hospitals with the same measures. Any meaningful comparison of hospitals should be done between hospitals that provide similar types of care to similar types of patients. We are committed to providing safe, high-quality patient care, and we encourage patients to look at the particular measures that most closely pertain to their needs and discuss the information with their caregiver.”