Determining the value proposition of surgical care in CMS star rated hospitals.

ABSTRACT

BACKGROUND: CMS Hospital Quality Star ratings reflect the quality of care given to patients. It is hypothesized that increased Star-rating is associated with higher cost and that the value proposition is diminished. METHODS: This study used the Florida AHCA inpatient dataset, CY2019. Partial colectomy was selected as a representative inpatient surgical procedure. Analysis was performed on this data to compare high and low Star-rated hospitals. RESULTS: Total costs were equivalent among all Star levels on initial analysis. In a propensity matched comparison with 1 Star, 5 Star hospitals had significantly lower length-of-stay and ICU, anesthesia, radiology and lab costs, and conversely, had higher total (+2%), operating room and med-surg supply costs. CONCLUSIONS: These results demonstrate that total colectomy costs are functionally equivalent among the CMS 1- and 5- Star categories. The results indicate that higher CMS Star ratings fulfill the value proposition and indeed offer higher quality without significantly increased cost.