Despite Mayo Clinic being ranked the top hospital in the nation by U.S. News and World Report, a new federal ranking system gives the clinic's flagship campus in Rochester four out of five stars.
The federal government launched the star-rating system last week for hospitals. It's based on surveys filled out by patients about their hospital experiences. Nationwide, only 251 hospitals earned a five-star rating, which is about 7 percent of all hospitals Medicare judged, according to a Kaiser Health News analysis.
No hospitals in southeastern Minnesota got the top rating. Mayo Clinic Hospital — Saint Marys Campus and Olmsted Medical Center Hospital received four stars. Mayo Clinic's branch campuses in Phoenix, and Jacksonville, Fla., each received a five-star rating, as did Mayo Clinic Health System — New Prague.
While the new star rating provides some valuable information, it's important for patients not to base their decisions about where to seek care solely on this information, said Dr. Sandhya Pruthi, Mayo Clinic director of patient experience.
Pruthi said the clinic takes the patient experience surveys seriously and works to improve care based on the results. But she said questions remain about Medicare's very complex methodology for analyzing the data and translating it into star ratings. Extremely small differences in scores can make the difference between a hospital getting three stars or four stars.
ADVERTISEMENT
"Mayo Clinic obviously thanks patients who complete these surveys because it has helped us to understand what we do well and where we can do better. So there's no question we really do value these surveys," Pruthi said.
Medicare's new rating system focuses on 11 areas of the patient experience, including how well nurses and doctors communicated, how well patients understood their care and whether they would recommend hospitals to others. In the case of Mayo Clinic Hospital — Saint Marys Campus, 90 percent of those surveyed said they would definitely recommend the hospital to others. The lowest score centered on patient education. Of those surveyed, 63 percent said they "strongly agree" that they understood their care when they left the hospital.
Olmsted Medical Center Hospital in Rochester also received a four-star rating, which OMC spokesman Jeremy Salucka said "is welcome validation of our ongoing process-improvement efforts and is a heartening reflection of the positive regard in which many of our patients hold us."
Of those surveyed, 85 percent of patients said they would definitely recommend OMC to others. Salucka said the data also highlights some areas where there is room for improvement and noted the data is nearly a year old, meaning it may not be reflective of the hospital's current performance.
The lowest rating handed out to hospitals in southeastern Minnesota was three stars, including to Mayo Clinic Health System — Albert Lea and Winona Health Services. Of the patients surveyed about their experiences at the Albert Lea site, only 63 percent said they would definitely recommend the hospital.
Pruthi said the Albert Lea score raises the question of whether some improvements could be made.
"It does give us something to think about," she said. "Are there areas for improvement there that we need to do better in?"
An accurate tool for measuring quality?
ADVERTISEMENT
Many in the hospital industry fear Medicare's five-star scale won't accurately reflect quality and might place too much weight on patient reviews, which are just one measurement of hospital quality. Medicare also reports the results of hospital care, such as how many died or got infections during their stay, but those are not yet assigned stars.
"We want to expand this to other areas like clinical outcomes and safety over time, but we thought patient experience would be very understandable to consumers so we started there," Dr. Patrick Conway, chief medical officer for the federal Centers for Medicare & Medicaid Services, or CMS, said in an interview.
Many of the facilities that earned five-star ratings are small specialty hospitals that focus on lucrative elective operations, such as spine, heart or knee surgeries. They have traditionally received more positive patient reviews than have general hospitals, where a diversity of sicknesses and chaotic emergency rooms make it more likely patients will have a bad experience.
On average, hospitals scored highest in Maine, Nebraska, South Dakota, Wisconsin and Minnesota. Thirty-four states had zero one-star hospitals. Hospitals in Maryland, Nevada, New York, New Jersey, Florida, California and the District of Columbia scored lowest on average. Thirteen states and the District of Columbia did not have a single five-star hospital.
In total, Medicare assigned star ratings to 3,553 hospitals based on the experiences of patients who were admitted between July 2013 and June 2014. 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.
Some groups that do their own efforts 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 consumers would flock to the government's rating without an aggressive effort to make them aware of it.
"It's nice they're going to try to be more consumer friendly," he 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."
