Hospitals that serve more dually eligible (Medicare and Medicaid) patients have lower star ratings under the Medicare Compare methodology of rating providers, according to a new analysis.

Those Medicare star ratings are based on five quality measure groups – mortality, readmission, patient experience, safety, and timely and efficient care – and hospitals that serve greater numbers of dually eligible patients especially lag on readmissions and patient experience scores and have higher mortality rates while patients are in the hospital, within 30 days of discharge, and within one year of discharge.  The latter is generally attributed to such patients suffering from more comorbidities than other hospital patients.

Such findings suggest a need to do a better job of risk adjusting the quality measures on which Medicare Compare scores are based.  The Alliance of Safety-Net Hospitals has long maintained that better risk adjustment is needed in Medicare quality measures and was successful in leading an effort to persuade the Centers for Medicare & Medicaid Services to do a better job of risk-adjusting its hospital readmissions reduction program to reflect the special challenges community safety-net hospitals face because they serve more disadvantaged patients who have struggled with access to care over the years.

Learn more about the challenges inherent in risk-adjusting the key measures on which Medicare rates and scores hospitals in its Medicare Compare star ratings from the Fierce Healthcare article “Dual-eligible patients impact hospitals’ star ratings, but blanket methodology adjustments aren’t the answer, researchers say.”