The Medicare program has developed a system for rating the overall care provided by hospitals based on a variety of measures that reflect common conditions that hospitals treat, such as heart attacks or pneumonia. Hospitals may perform more complex services or procedures not reflected in the measures on Hospital Compare. The overall hospital rating is the Medicare program’s attempt to summarize how well each hospital performed, on average, compared to other hospitals in the U.S.
The overall hospital rating ranges from 1 to 5 stars. The more stars, the better a hospital performed on the available quality measures. The most common overall hospital rating is 3 stars. Learn more about hospital overall rating calculations by clicking here.
Hospitals report data to the Centers for Medicare & Medicaid Services, the federal agency that runs the Medicare program, through the Hospital Inpatient Quality Reporting (IQR) Program and the Hospital Outpatient Quality Reporting (OQR) Program. The Hospital Compare overall hospital rating includes up to 57 of these measures in the overall rating calculation. Learn more.
Some of the measures used to calculate the overall hospital rating are based only on data from Medicare patients and some are based on data from all patients. The claims-based measures, which include the mortality, readmission, complications, PSI-90, and imaging efficiency measures, are calculated using Medicare fee-for-service (FFS) hospital claims data only. The process of care, healthcare-associated infection (HAI), and HCAHPS Survey measures include data from all payers.