It’s the First Time VA Facilities Received Star Ratings
Click to Enlarge: Flowchart of the Seven-Step Overall Hospital Quality Star Rating Methodology Source: Yale New Haven Health Services Corporation – Center for Outcomes Research & Evaluation (CORE)
WASHINGTON — The first time VA hospitals were included in the Centers for Medicare & Medicaid Services annual Overall Hospital Quality Star Ratings, they aced it.
In fact, 67% of VA hospitals received either 4 or 5 stars in the ratings, compared to only 41% of non-VA hospitals. This was the first time VA hospitals were included in the CMS Star Ratings.
Five categories are included in the CMS ratings—mortality, safety of care, readmission, patient experience and timely and effective care—on a 1-5 scale, with 5 being the highest quality level.
That follows the news that VA hospitals outperformed non-VA hospitals on all 10 core patient satisfaction metrics in the recent Hospital Consumer Assessment of Healthcare Providers and Systems Star Ratings.
“Our job at VA is to deliver the best possible care to every Veteran who walks through our doors,” said VA Under Secretary for Health Shereef Elnahal, MD, in a press release. “While we’re very proud of these findings, there is still work to do. We will study these results, learn from them, and continue to improve until we’re delivering world-class care to every veteran, every time.”
July 2023 Update
The Star Ratings are posted on Care Compare, a website “designed for consumers to use along with their healthcare provider to make decisions on where to receive care,” according to CMS. The July 2023 update revealed that, of 3,076 hospitals which received ratings as part of the assessment, only about 16% got the coveted 5-star rating, while about 26% got a 4-star rating.
While VHA data previously was included with all other hospitals at the measure level, they were not eligible to receive Star Ratings and were excluded from all Star Rating calculations. That changed with this reporting period. “As finalized in the Calendar Year 2021 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule (CMS 1736-P), Veterans Health Administration (VHA) hospitals reporting data for measures included in Star Ratings are included in Star Rating calculations alongside non-VHA hospitals and are eligible to receive their own Star Ratings,” CMS explained.
According to CMS, the Star Rating is intended for acute care hospitals and excludes specialty hospitals—such as cancer hospitals or inpatient psychiatric facilities—or ambulatory surgical centers prior to applying any measure selection criteria. Based on these criteria, 114 VA facilities received a CMS star rating and 23 were not rated.
The star ratings are based on data collected between July 2018 and March 2022
A recent review also found that VA care is consistently as good as or better than non-VA care in terms of clinical quality and safety. “Access, cost/efficiency, and patient experience between the two systems are not well studied. Further research is needed on these outcomes and on services widely used by veterans in VA-paid community care, like physical medicine and rehabilitation,” wrote the authors from the Los Angeles VA Healthcare System and the RAND Corp.1
The study team included 37 after screening 2415 titles. Of those, 12 compared VA and VA-paid community care. Most of the studies assessed clinical quality and safety, while others looked at ease of access. Only six studies assessed patient experience and six assessed cost or efficiency.
The report in the Journal of General Internal Medicine found that clinical quality and safety of VA care was better than or equal to non-VA care in most studies. “Patient experience in VA care was better than or equal to experience in non-VA care in all studies, but access and cost/efficiency outcomes were mixed,” the authors pointed out.
- Apaydin EA, Paige NM, Begashaw MM, Larkin J, Miake-Lye IM, Shekelle PG. Veterans Health Administration (VA) vs. Non-VA Healthcare Quality: A Systematic Review. J Gen Intern Med. 2023 Jul;38(9):2179-2188. doi: 10.1007/s11606-023-08207-2. Epub 2023 Apr 19. PMID: 37076605; PMCID: PMC10361919.