Survey of patients' experiences (HCAHPS) star ratings
The Centers for Medicare & Medicaid Services (CMS) has developed 12 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 11 HCAHPS measures publicly reported on Hospital Compare, CMS created 11 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)
- Pain management† (questions 13, 14)
- Communication about medicines (questions 16, 17)
- Discharge information (questions 19, 20)
- Care transition (questions 23, 24, 25)
- Cleanliness of hospital environment (question 8)
- Quietness of hospital environment (question 9)
- Hospital rating (question 21)
- Willingness to recommend hospital (question 22)
HCAHPS summary star rating
In addition to star ratings for the 11 HCAHPS measures, CMS is introducing the HCAHPS summary star rating, which is the average of the star ratings of the 11 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 7 star ratings from each of the 7 HCAHPS composite measures.
- Nurse communication, doctor communication, responsiveness of hospital staff, pain management†, 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 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. CMS assigns 1,2,3,4, or 5 whole stars for each HCAHPS measure by applying statistical methods that use relative distribution and clustering. HCAHPS scores are then adjusted for the effects of patient mix, survey mode, and quarterly weighting through a series of steps.
The star rating for each of the 11 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 email@example.comExit Disclaimer - Opens in a new window or 1-888-884-4007.
† Note: CMS is reviewing the pain management questions on the HCAHPS Survey for possible revision.