Survey of patients' experiences (HCAHPS) star ratings
The Centers for Medicare & Medicaid Services (CMS) has developed HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) star ratings to make it easier for consumers to use the information on the Hospital Compare website and to spotlight excellence in healthcare quality.
HCAHPS star ratings
Using data from the 10 HCAHPS measures publicly reported on Hospital Compare, CMS created 10 HCAHPS star ratings. Star ratings for composite topics (listed below) combine multiple questions from the HCAHPS Survey. For instance, the nurse communication star rating combines data from 3 questions from the HCAHPS Survey. Star ratings for individual and global topics represent individual questions on the HCAHPS Survey.
- Nurse communication (questions 1, 2, 3)
- Doctor communication (questions 5, 6, 7)
- Responsiveness of hospital staff (questions 4, 11)
- Communication about medicines (questions 13, 14)
- Discharge information (questions 16, 17)
- Care transition (questions 20, 21, 22)
- Cleanliness of hospital environment (question 8)
- Quietness of hospital environment (question 9)
- Hospital rating (question 18)
- Willingness to recommend hospital (question 19)
HCAHPS summary star rating
In addition to star ratings for the 10 HCAHPS measures, CMS is introducing the HCAHPS summary star rating, which is the average of the star ratings of the 10 topic-specific HCAHPS measures. The HCAHPS summary star rating combines information about different aspects of patient experience of care to make it easier for you to compare hospitals. The HCAHPS summary star rating is constructed from the following components:
The 6 star ratings from each of the 6 HCAHPS composite measures.
- Nurse communication, doctor communication, responsiveness of hospital staff, communication about medicines, discharge information, and care transition.
A single star rating for the HCAHPS individual topics.
- The average of the star ratings assigned to cleanliness of hospital environment and quietness of hospital environment.
A single star rating for the HCAHPS global topics.
- The average of the star ratings assigned to hospital rating and willingness to recommend the hospital.
Which patients are included
The HCAHPS survey is administered to a random sample of adult patients across medical conditions between 48 hours and 6 weeks after discharge; the survey isn't restricted to Medicare beneficiaries.
Where the information comes from
To get HCAHPS star ratings, hospitals must have at least 100 completed HCAHPS surveys over a given four-quarter period. In addition, hospitals must be eligible for public reporting of HCAHPS measures. Hospitals with fewer than 100 completed HCAHPS surveys don't get star ratings; however their HCAHPS measure scores are publicly reported on Hospital Compare.
HCAHPS survey responses are first converted to linear mean scores for each HCAHPS measure and then adjusted for patient mix and mode of survey administration. Next, a statistical clustering algorithm groups hospitals into 5 star categories for each HCAHPS measure. For more details, please see the Technical Notes for HCAHPS Star Ratings, which can be found on the official HCAHPS On-Line Web site.- Opens in a new windowExit Disclaimer - Opens in a new window CMS assigns 1,2,3,4, or 5 whole stars for each HCAHPS measure by applying statistical methods that use relative distribution and clustering.
The star rating for each of the 10 HCAHPS measures is determined by applying a statistical clustering algorithm to the individual measure scores. This clustering algorithm identifies the ‘gaps’ in the data and creates 5 categories (one for each star rating) so scores of hospitals in the same star rating category are as similar as possible, and scores of hospitals with different star ratings are as different as possible. This clustering algorithm is the same one employed by CMS to determine Medicare Part C and Part D star ratings.
- HCAHPS star rating technical notes- Opens in a new windowExit Disclaimer - Opens in a new window available on the official HCAHPS survey website.- Opens in a new windowExit Disclaimer - Opens in a new window
- Materials from the October 2014 MLN ConnectsTM National Provider Call.- Opens in a new window
To communicate with CMS staff, please send an email to Hospitalcahps@cms.hhs.gov.
For information and technical assistance, please contact the HCAHPS Project Team at firstname.lastname@example.orgExit Disclaimer - Opens in a new window or 1-888-884-4007.