Highlights
- •The Centers for Medicare and Medicaid Services “Star” rating, typically seen as a proxy for quality, is also indicative of value of care delivered.
- •In a colectomy model, 1- and 5- Star hospitals have functionally equivalent total costs, meaning the 5-Star hospitals deliver excellent value.
- •In a propensity matched comparison, 1- and 5- Star hospitals differ in that 5-Star hospitals have a lower length-of-stay, higher operating costs, and higher medical and surgical supply costs.
Abstract
Background
CMS Hospital Quality Star ratings reflect the quality of care given to patients. It
is hypothesized that increased Star-rating is associated with higher cost and that
the value proposition is diminished.
Methods
This study used the Florida AHCA inpatient dataset, CY2019. Partial colectomy was
selected as a representative inpatient surgical procedure. Analysis was performed
on this data to compare high and low Star-rated hospitals.
Results
Total costs were equivalent among all Star levels on initial analysis. In a propensity
matched comparison with 1 Star, 5 Star hospitals had significantly lower length-of-stay
and ICU, anesthesia, radiology and lab costs, and conversely, had higher total (+2%),
operating room and med-surg supply costs.
Conclusions
These results demonstrate that total colectomy costs are functionally equivalent among
the CMS 1- and 5- Star categories. The results indicate that higher CMS Star ratings
fulfill the value proposition and indeed offer higher quality without significantly
increased cost.
Keywords
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Article Info
Publication History
Accepted:
November 17,
2022
Received in revised form:
October 31,
2022
Received:
July 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc.
