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Lower rating to cost MU Health Care $800,000 in Medicare payments

Lower rating to cost MU Health Care $800,000 in Medicare payments

March 2nd, 2019 by Joe Gamm in Local News

Federal authorities on Thursday issued their annual star ratings on Hospital Compare — a site that allows consumers to compare information about the quality of care at more than 4,000 Medicare-certified hospitals.

Area hospitals received a variety of ratings.

St. Mary’s Hospital in Jefferson City received four out of five possible stars. It is the second consecutive year the hospital has received four stars, according to Jessica Royston, marketing and communications manager for SSM Health’s Mid- and Northwest Missouri regions. Consumers may check hospitals’ ratings at medicare.gov/hospitalcompare

The site warns the complexity of procedures or services provided by hospitals are not reflected in the results, so it’s difficult to compare some hospitals.

Capital Region Medical Center received three stars.

University of Missouri Health Care received a single star, which was a reduction from previous years. The health system provided information about the change.

As a Level 1 trauma center and a tertiary care facility — one that receives referrals from primary or secondary health care facilities — MU Health Care oftentimes receives desperately ill patients, according to a facts page provided by the hospital. And other hospitals transfer people suffering from chronic or complex health conditions to the institution.

Previously, those patients were excluded from many of the calculations that go into the star rating. A recent change in that calculation negatively affected the most recent rating, according to the hospital.

“These ratings do not fully reflect the progress MU Health Care has made in a number of key areas critical to patient care, including marked improvements — according to the Centers for Medicare and Medicaid Services (CMS) from 2017 through 2018 — in patient experience, effectiveness of care and timeliness of care,” according to the facts page.

The page also states in addition to including the number of patients who transfer into the hospital from other hospitals, CMS used a “weighted” safety of care calculation. Patient Safety Indicators (26 indicators that provide information on safety-related adverse events occurring in hospitals) went from a weight of 15 percent in safety care to 70 percent, which negatively affected MU Health Care.

Because MU Health Care has scored lower, it will receive less money in the coming year based on the CMS’ “hospital acquired conditions” program.

The reduction will be based on data collected from 2014-17 and is equal to 1 percent of Medicare payments, or about $800,000 from October 2018 through this coming July.

“While we never want to face any reduction in reimbursement,” the fact page states, “we are in strong financial standing and will continue to focus on sound and proactive cost management that promotes growth and development.”