National Quality Forum Releases Multistakeholder Recommendations for Strengthening the Overall Hospital Star Rating System 

NOV 06, 2019

CONTACT: Proof Strategies

National Quality Forum Releases Multistakeholder Recommendations for Strengthening the Overall Hospital Star Rating System
Collaboration across the healthcare measurement enterprise identifies actionable recommendations to improve transparency of healthcare quality

- The National Quality Forum (NQF) released key recommendations to address challenges and opportunities for improving the transparency, fairness, and usefulness of the Hospital Star Ratings program resulting from the Hospital Quality Star Rating Summit held earlier this year in Washington, DC.

In 2016, The Centers for Medicare & Medicaid Services (CMS) introduced the Hospital Star Rating System to provide healthcare consumers with accessible quality performance data to inspire informed healthcare decision-making. Since its launch, the healthcare community has split between support for the easily understandable format of the five-star ratings while raising concerns about the methodology employed by the system and confidence in the validity of the Star Ratings performance results.

To address these concerns, NQF convened a Summit of more than 20 experts representing the array of stakeholder perspectives—patients, consumers, employers and purchasers, healthcare providers, statisticians, and health plans— to work together to consider respective concerns and propose considerations for CMS. Based on the Expert Panel’s deliberations regarding opportunities to improve the program as well as its expertise in measurement science and understanding of stakeholder priorities, NQF identified three actionable recommendations.

  1. Be clear about the program intent and goals. The program’s methodology and design elements should align with the underlying intent and user needs.
  2. Be transparent about what the Star Ratings do and do not convey. The Star Ratings are designed to provide a summary of measures on Hospital Compare to support consumer understanding. Clear communication about the interpretation of the program and its methods is imperative.
  3. Design data presentation to meet consumer priorities and other user needs. There is an opportunity to enhance the presentation of the Star Ratings and user interaction with the summary data to make the program more actionable and relevant.

“The healthcare leaders on this Technical Expert Panel have demonstrated leadership and commitment to improving health outcomes,” said Cristie Upshaw Travis, Chief Executive Officer of the Memphis Business Group and co-chair of the Hospital Quality Star Rating Summit TEP. “These recommendations will strengthen the Hospital Star Rating System as a meaningful vehicle to help every patient in every community confidently engage in important care decisions.”

Enhancing the Hospital Star Rating System requires collaboration across the healthcare ecosystem with future-focused ideas that will adapt to the evolving nature of healthcare delivery systems.

“We recognize that informed consumers are critical to advancing an equitable and patient-centered healthcare delivery system,” said Nancy Foster, co-chair of the Hospital Quality Star Rating Summit TEP and Vice President for Quality and Patient Safety Policy at the American Hospital Association. “NQF provides a unique forum for all voices to collaborate to strengthen this important resource to support patients in their healthcare decisions.”

Access the final recommendations provided to CMS for consideration and learn more about the Hospital Quality Star Rating Summit outcomes.


About the National Quality Forum
The National Quality Forum (NQF) works with members of the healthcare community to drive measurable health improvements together. NQF is a not-for-profit, membership-based organization that gives all healthcare stakeholders a voice in advancing quality measures and improvement strategies that lead to better outcomes and greater value. Learn more at