Supporting Strategic Investments in Healthcare Quality Improvement

The Center for Medicaid and Medicare (CMS) STAR rating system is a quality measurement framework that assigns hospitals a rating from 1 to 5 stars based on 48 different quality measures across five categories: mortality, safety, readmission, patient experience, and process measures. This rating system has significant financial implications for hospitals through Medicare payment adjustments in programs like the Hospital Readmission Reduction Program (HRRP) and the Hospital Value Based Purchasing Program (HVBP), while also influencing public perception and patient choice.

The CMS Star Quality Investment Optimizer system standardizes and weighs these measures to create a single, easy-to-understand rating that helps patients compare hospitals and make informed healthcare decisions. This project includes the development of a Python-based calculator tool that significantly improves the speed of existing SASbased calculations, allowing for high-speed simulation of the scoring impacts of hypothetical strategic investments. The tool allows hospitals to input their statistics and receive detailed analysis of their performance, including the impact of individual measures on their overall score. The presentation also analyzes the University of Kentucky’s specific performance, identifying key negative and positive features affecting their rating, and demonstrates how a 10% improvement in certain metrics could significantly impact their score.