In a recently released data assessment by the Centers for Medicare & Medicaid Services (CMS), more than two-thirds of 114 Department of Veterans Affairs (VA) facilities received four-or five-star ratings, surpassing private hospitals by a remarkable 26 percentage points.
This report marks the first-ever quality assessment of VA hospitals conducted by CMS, a federal agency under the Department of Health and Human Services.
The assessment considers mortality rates, patient safety, hospital readmissions, patient experience, and timely and effective care to determine Overall Quality Star Ratings for hospitals across the United States.
Among the 4,654 hospitals assessed nationwide, only 10% received five-star ratings, and 17% received four-star ratings.
About 19% were awarded three stars, 14% got two stars, and 5% received the lowest rating, one star.
The remaining 34% of hospitals were not rated due to either not meeting qualification thresholds or lacking sufficient metrics for evaluation.
In comparison, the results for VA hospitals were remarkably positive, with 30% receiving five stars, 37% earning four stars, 15% receiving three stars, 11% obtaining two stars, and 8% (nine facilities) receiving one star.
However, 23 Veterans Health Administration medical centers did not receive a rating from CMS as they did not meet the inclusion criteria.
CMS does not rate facilities with dwindling numbers of cases or incidents that align with its assessment criteria.
Similarly, specialty hospitals, ambulatory surgical centers, and some inpatient care facilities, such as psychiatric hospitals, were not included in the assessment.
The abundance of four-and five-star ratings for Veterans Health Administration hospitals aligns with another favorable report released in June by CMS.
In this earlier assessment, 72% of VA facilities received four-or five-star ratings for patient experience based on surveys measuring patient satisfaction with their care.
VA officials have been working in collaboration with CMS for five years to be part of these annual ratings, enabling Veteran patients to compare VA facilities with private-sector hospitals.
Gerard Cox, VA’s Assistant Undersecretary for Health for Quality and Patient Safety, stated that since 2019, the department has focused on becoming a “high reliability organization,” prioritizing operational improvements, expertise promotion, and failure prevention.
The positive CMS star ratings validate the impact of these efforts, reinforcing the VA’s commitment to providing safe and effective care to Veterans.
While most VA facilities received favorable ratings, the report also highlighted nine facilities that earned one-star ratings, indicating that they significantly underperformed in specific measurements, such as death rates for patients with heart failure, surgical complications, pneumonia, readmission rates for certain ailments, hospital-acquired infections, and patient satisfaction, among others.
The facilities with the lowest ratings include the James J. Peters VA Medical Center in Bronx, New York; Bay Pines VA Health Care System and West Palm Beach VA Medical Center in Florida; New Mexico VA Health Care System in Albuquerque; VA Pittsburgh Health Care System; Providence VA Medical Center in Rhode Island; Lt. Col. Luke Weathers Jr. VA Medical Center in Memphis, Tennessee; Overton Brooks VA Medical Center in Shreveport, Louisiana; and VA Caribbean Health Care System in San Juan, Puerto Rico.
Critics of the rankings point out that they do not consider the socioeconomic status of patients or the surrounding community, which may lack access to routine healthcare and experience worse health outcomes during treatment for acute and chronic conditions.
Additionally, CMS’s method of calculation may disadvantage smaller facilities or hospitals with a small number of cases that meet eligibility criteria.
In response to the ratings, VA Undersecretary of Health Dr. Shereef Elnahal assured that the department has identified and worked with many of the facilities that require assistance.
He suggested that some of the low-performing facilities may have already improved since the CMS ratings were based on data from July 2018 to March 2022.
Dr. Elnahal anticipates that these improvements will be reflected in future iterations of the star ratings.
The VA has a history of maintaining its own internal star ratings, but in late 2019, it decided to discontinue their public release and instead focused on sharing data on wait times, patient satisfaction ratings, medical services, and quality assessments.
The decision came after USA Today published a series of articles about the internal system, prompting the VA to make the ratings public.
However, three years later, then-VA Secretary Robert Wilkie stated that the internal system provided “little value in helping Veterans make informed health decisions.”
