CMS Hospital Star Rating

The CMS Hospital Star Rating is a one-to-five-star score Medicare assigns to about 4,500 hospitals each year and publishes on its Care Compare website. It rolls up roughly 45 quality measures in five groups: mortality, safety of care, readmissions, patient experience, and timely and effective care. It is the closest thing the country has to a single government grade for a hospital.

The distribution is worth knowing. In a typical year about 10 percent of rated hospitals get five stars, 25 percent get four, 30 percent get three, 20 percent get two and 6 percent get one, with the rest not rated because they are too small or too specialized to have enough data. Big-name academic medical centers do not always score high, partly because they take the sickest patients and partly because patient experience scores tend to be lower at very large hospitals. Small, focused hospitals, including many orthopedic and surgical specialty hospitals in Texas, often score five stars. The rating is a general-purpose measure. If you need heart surgery, the hospital's specific mortality and complication rates for heart surgery, which are also on Care Compare, matter more than the overall star count. The star rating and the Leapfrog grade measure overlapping but different things, and a hospital can do well on one and poorly on the other.

The takeaway: use the star rating as a first screen and then look at the procedure-specific measures for what you actually need. TruePrice shows the quality score next to every price for the same reason: a low price at a one-star hospital is not a bargain.