Blog | Quality Measures

CMS releases the 2021 hospital star ratings

Blog | Quality Measures

CMS releases the 2021 hospital star ratings

CMS released its list of star ratings for hospitals on the Care Compare website, providing consumers with indications of a hospital’s quality based on a five-star scale.

More than 4,500 hospitals were eligible to receive star ratings. On the far sides of the scale, 455 hospitals have five stars and 204 have only one, while nearly 1,200 were ineligible to be rated due to insufficient data on quality measures. Becker’s broke out the five-star hospitals by state.

CMS compiles the star ratings by assessing hospitals in five sets of quality measures: mortality, safety of care, readmissions, patient experience, and timeliness and effectiveness of care. Hospitals report their own data and are eligible to receive a rating if they report at least three measures in each of three or more measure groups, including either mortality or safety of care.

The star ratings reflect a hospital’s performance on those measures relative to other U.S. hospitals in a “peer group,” which is based on the number of measure sets in which a hospital reports enough data to be scored.

The American Hospital Association released a statement April 29 supporting some of the recent changes to the star-rating methodology, as established in the 2021 Outpatient Prospective Payment System (OPPS) final rule. Those alterations “have made the star ratings easier to interpret, more insightful for hospitals working to improve their quality of care, and more balanced in favor of high-priority topics, like infections,” according to the statement from Ashley Thompson, senior vice president for public policy analysis and development.

But concerns remain, including that “CMS’s failure to account for social risk factors in calculating performance on measures like readmissions biases the ratings against those hospitals caring for more vulnerable patients.”

The statement also calls for improvement in the peer-grouping approach, which was implemented in the 2021 OPPS rule.  

“Finally, and importantly, because the star ratings methodology has changed so frequently and significantly since its inception, comparing a hospital’s latest overall star rating with a previous rating could be very misleading,” Thompson said in the statement.

CMS states that consumers should consider factors aside from star ratings when choosing where to seek care, including guidance from their physician. In addition, while rates of infections and complications are included in the safety of care domain, consumers may want to pay special attention to those data and to patient survey results.

About the Author

Nick Hut

is a senior editor with HFMA, Westchester, Ill. (


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