Pentagon & Congress

VA drops its star ratings system for hospitals

The Department of Veterans Affairs will no longer issue star ratings for its 146 medical centers.

VA officials announced last month that individual VA hospitals will instead post measures such as wait times, patient satisfaction ratings, medical services and quality assessments on their individual websites.

The change, VA leaders said, will allow veterans to compare VA facilities with nearby public and private medical centers.

“Star ratings were developed as an internal tool meant to compare one VA facility to another,” VA Secretary Robert Wilkie said in a statement. “These ratings do not provide insight as to how our hospitals stack up against nearby non-VA facilities and are therefore of little value in helping veterans make informed health care decisions."

VA leaders say the move to abandon the system, first made public in a series of articles in USA Today, will improve transparency.

The ratings were often “misinterpreted,” the release stated, as they compare VA facilities by ranking them across the department’s health care system, rather than by “geography, population characteristics or unique care offerings” of neighboring non-VA facilities.

“It was found that the VA hospital star ratings were unfortunately perceived as equivalent to hotel, Amazon, or Yelp ratings,” explained Thomas Wisnieski, director of the North Florida/South Georgia Veterans Health System, in a note to veterans.

While the ratings did not allow veterans to compare VA facilities with local medical centers, they did give patients an idea of how their VA hospital stacked up against the others and whether it was on the upwing or declining.

When the ratings were first published in 2016, 10 medical facilities had a 1-star rating, while 90 had shown “significant improvement” over a set of baseline measures.

By fiscal 2019, the number of medical facilities that received a 1-star rating was nine, including three that had resided on the list since 2016: El Paso, Texas; Memphis, Tenn., and Phoenix.

When the secretive ratings were published, officials downplayed their importance, saying the system gave VA officials a snapshot on how facilities were doing but had little public utility.

Former VA Secretary Dr. David Shulkin told USA Today that the ratings weren’t published because VA didn’t want veterans to assume that if their hospital received one star, they wouldn’t get quality care and would stop going.

While Shulkin had concerns about publishing the measures, by 2018, Secretary Robert Wilkie lauded the results when they were published. That year, the system showed improvements at 66 percent of VA medical centers and nine facilities had a one-star rating.

“With closer monitoring and increased medical center leadership and support, we have seen solid improvements at most of our facilities,” Wilkie said at the time. “Even our highest performing facilities are getting better, and that is driving up our quality standards across the country.”

In December, however, Wilkie said the new facility-based websites will “make it easier for veterans to choose the best possible care close to home, when and where they need it.”

The websites provide information on wait times, patient satisfaction, quality of care and provider access data for an individual VA and all major nearby hospital systems.

In lieu of the star system, VA will continue to publish its Strategic Analytics for Improvement and Learning, or SAIL data, that gives an in-depth look of 14 metrics quality of care measures at all VA medical centers.

Veterans who click through the system can still find which hospitals have the highest and lowest marks in categories such as death rates, surgical complications, safety, in-hospital infection rates and more.

In defending their decision to drop the star rating system, VA officials added that focus groups showed that veterans didn’t actually look at the ratings when making a decision about their health provider.

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