April 17--Chicago-area hospitals did not dazzle the federal government with their efforts to satisfy patients, according to results of a new star rating system based on patients' appraisals.
Six Chicago hospitals received the lowest possible rating of one star, according to Medicare data posted to the federal Hospital Compare site Thursday.
In Cook and the collar counties, just one hospital received the top score of five stars: Midwestern Regional Medical Center, a cancer treatment center in Zion.
The ratings are based on 11 facets of patient experience as ranked by the patients themselves, including how well doctors and nurses communicated, how well patients believed their pain was addressed and whether they would recommend the hospital to others.
Of the 65 hospitals rated in Cook County and nearby counties, 14 received four stars. In Illinois, 13 of 147 hospitals received five stars, 62 received four stars, 50 got three stars and 16 got two stars.
The six one-star ratings went to Jackson Park Hospital, Norwegian-American Hospital, Roseland Community Hospital, St. Anthony Hospital, South Shore Hospital and St. Bernard Hospital -- all in Chicago.
In assigning stars, Medicare compared hospitals against each other, essentially grading on a curve. The website notes that "a 1-star rating does not mean that you will receive poor care from a hospital" and that "we suggest that you use the star rating along with other quality information when making decisions about choosing a hospital."
Many in the hospital industry fear Medicare's five-star scale places too much weight on patient reviews, which are just one measure of hospital quality. Medicare also reports information on the results of hospital care, such as how many patients died or contracted infections during their stay, but those are not yet associated with star ratings.
"Hospitals welcome information that can help patients and consumers make informed decisions, but we also caution people not to make broad conclusions about hospitals based on one set of ratings," said Illinois Hospital Association spokesman Danny Chun.
Evaluating hospitals is becoming increasingly important as more insurance plans limit patients' choices. Medicare already uses stars to rate nursing homes, dialysis centers and private Medicare Advantage insurance plans. Although the Hospital Compare website includes more than 100 quality measures about hospitals, many are hard to decipher and there is little evidence that consumers use the site much.
Nationally, Medicare awarded five stars to 251 hospitals, about 7 percent of all the hospitals Medicare judged, a Kaiser Health News analysis found. Many are small specialty hospitals that focus on lucrative elective operations such as spine, heart or knee surgeries. Those facilities traditionally receive more positive patient reviews than do general hospitals, where a wide variety of ailments and chaotic emergency rooms make it more likely that patients will have a bad experience.
Many of the nation's leading hospitals received middling ratings, while comparatively obscure local hospitals and others that specialized in lucrative surgeries frequently received the most stars.
A few five-star hospitals are part of well-respected systems, such as the Mayo Clinic's hospitals in Phoenix, Jacksonville, Fla., and New Prague, Minn. Mayo's flagship hospital in Rochester, Minn., received four stars.
Medicare awarded three stars to some of the nation's most esteemed hospitals, including Cedars-Sinai Medical Center in Los Angeles and NewYork-Presbyterian Hospital in Manhattan. The government gave its lowest rating of one star to 101 hospitals, or 3 percent.
In total, Medicare assigned star ratings to 3,553 hospitals based on the experiences of patients who were admitted from July 2013 through June 2014. Surveys are either mailed or conducted by phone with a random sample of adult patients between 48 hours after discharge and six weeks after discharge.
Medicare gave out four stars to 1,205 hospitals, or 34 percent of those it evaluated. Another 1,414 hospitals -- 40 percent -- received three stars, and 582 hospitals, or 16 percent, received two stars. Medicare did not assign stars to 1,102 hospitals, primarily because not enough patients completed surveys during that period.
While the stars are new, the results of the patient satisfaction surveys are not. They are presented on Hospital Compare as percentages, such as the percentage of patients who said their room was always quiet at night. Often, hospitals differ by just a percentage point or two, and until now Medicare did not indicate what differences it considered significant.
The Centers for Medicare Medicaid Services also uses patient reviews in doling out bonuses or penalties to hospitals based on their quality each year.
Some other groups that attempt to evaluate hospital quality questioned whether the new star ratings would help consumers. Evan Marks, an executive at Healthgrades, which publishes lists of top hospitals, said it was unlikely that consumers would flock to the government's rating without an aggressive effort to make people aware of it.
"It's nice they're going to try to be more consumer-friendly," Marks said. "I don't see that the new star rating itself is going to drive consumer adoption. Ultimately, you can put the best content up on the Web, but consumers aren't going to just wake up one day and go to it."
Jean Chenoweth, an executive at Truven Health Analytics, which also publishes a list of top hospitals, said she feared hospital marketing departments would oversell the meaning of the stars.
"It would be very unfortunate and misleading if a hospital marketing department could claim to be a CMS five-star hospital and fail to mention it only reflected a patient's perception of care," she said.
Venteicher is a Tribune reporter. Rau is a reporter for Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.
wventeicher@tribpub.com
