Forsyth hospitals rank mediocre in CMS' 2023 ratings

The Centers for Medicare and Medicaid Services released July 27 its overall star rating for how 15 hospitals in the Triad and Northwest North Carolina are performing in terms of quality.

The rankings go from a low of one star to a high of five stars.

• Five stars: Ashe, Davie, Moses Cone, Watauga,

• Four stars: Northern of Surry County.

• Three stars: Forsyth, Hugh Chatham.

• Two stars: Alamance, Atrium Health Wake Forest Baptist, High Point, Lexington, Randolph, Thomasville.

• One star: UNC Rockingham, Wilkes

• Not rated: Alleghany, Clemmons, LifeBrite of Stokes, Medical Park, Old Vineyard Youth Services

Source: www.medicare.gov/hospitalcompare

Forsyth County's two primary hospitals are ranked at or below the national average for quality, according to the latest Hospital Compares rating from the Centers for Medicare and Medicaid Services.

Forsyth Medical Center received three out of five stars in its overall rating and from the patient survey, while Atrium Health Wake Forest Baptist received two stars in the overall rating and three from patients.

Meanwhile, Moses Cone Hospital received five stars overall, but just three from patients.

Other overall five-star hospitals of the 16 rated in the Triad and Northwest North Carolina were Ashe Memorial in Jefferson, Davie Medical Center in Mocksville and Watauga Medical Center in Boone.

CMS provided ratings for more than 4,000 hospitals nationwide based on more than 150 categories, with about 10% earning a five-star rating. The federal Affordable Care Act requires Medicare to use quality metrics in setting payments.

As has been its pattern, CMS did not issue an accompanying statement on the latest ratings.

However, CMS said the purpose of Hospital Compares is to "display hospital performance data in a consistent, unified manner to ensure the availability of credible information about the care delivered in the nation's hospitals."

"Only data from Medicare-certified hospitals are included."

The overall review provides quality measure information on:

• Process of care that shows whether or not a health-care provider gives recommended care based on guidelines, standards of care or practice parameters; that is, the treatment known to give the best results for most patients with a particular condition;

• Outcomes designed to reflect the results of care, rather than whether or not a specific treatment or intervention was performed;

• Patient experience of care is measured by a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay; and

• Imaging efficiency patterns, care transitions, emergency department efficiency, care coordination and patient safety.

Novant-affiliated hospitals rated were: Medical Park (not reviewed overall, five stars from patients); Thomasville (two stars overall, three stars from patients). Clemmons Medical Center was not reviewed.

Novant said in a statement that "while informative, quality measures alone do not reflect the intricacies of the patient experience, which is shaped by thousands of dedicated team members working together to ensure every individual feels cared for and safe."

"The CMS star rating systems and other quality index models rely on historical data ranging from two to five years old, which limits their usefulness for our teams and patients.

"Novant Health's Institute of Safety and Quality continuously tracks outcomes and trends, enabling our teams to make adjustments in real time as we work to provide the safest and highest quality care in the nation."

Other Baptist-affiliated hospitals rated were: High Point (two stars overall, three stars from patients); Lexington (two stars overall, three stars from patients); and Wilkes (one star overall, three stars from patients).

Baptist said in a statement that it "focuses on continuous performance improvement always - using an integrated, evidence-based approach."

"We recognize the importance of transparency in sharing hospital safety and quality data and do so willingly. Although some organizations use data that can be up to two years old, it's important to note that we use near-immediate internal measures and tools to strive for operational improvements we can make in real time.

"We also use direct feedback from our teammates and patients, including engagement and listening through our patient and family advisory councils, to improve on any patient safety and care in the moment, rather than waiting on yearly reports from outside agencies."

Included within the Moses Cone rating are affiliates Annie Penn Hospital in Reidsville, Cone Health Behavioral Health Hospital, Moses Cone, Wesley Long Hospital and Women's Hospital.

"It's great to know that some of the best health care is right in our own communities," says Dr. Carolyn Harraway-Smith, chief quality officer for Cone Health.

Medicare's chief measuring stick for hospitals - available at www.medicare.gov/hospitalcompare - also offers ratings in six inpatient and outpatient categories: complications and deaths; payment and value of care; unplanned hospital visits; survey of patients' experiences; timely and effective care; and psychiatric unit services.

"We have been posting star ratings for different facilities for a decade and have found that publicly available data drives improvement, better reporting and more open access to quality information for our Medicare beneficiaries," the agency said when introducing the ratings in 2015.

Medicare officials say the rankings are risk-adjusted to take into account the kinds of patients a hospital serves, such as a trauma center as Baptist.

Other prominent hospital ranking reports include from U.S. News & World Report, www.ahrq.gov, www.healthgrades.com, www.drscore.com and www.leapfroggroup.org.

For example, the latest Leapfrog patient-safety grades - released May 2 - had Baptist, Cone and Forsyth all rated at the "A" level for patient safety.

Leapfrog assigns letter grades from A to F to hospitals based on their ability to prevent errors, injuries, accidents and infections, and improve patient satisfaction.

The nonprofit Leapfrog is founded by larger employers and private health care purchasers. Its overall and individual category grades can reflect multiple years of review.

Medicare data tend to be considered the standard measuring stick in most categories, said David Meyer, senior partner for Keystone Planning Group LLC of Durham.

"Hospitals are sensitive to how the quality of their services is portrayed in these surveys," Meyer said.

"There is increasing pressure among employers, payers and the public for greater accountability of hospitals, foremost for them to justify the value of the expenditure and show improving quality."

[email protected]@rcraverWSJ