Journal of General Internal Medicine

, Volume 33, Issue 8, pp 1221–1223 | Cite as

Impact of Teaching Intensity and Sociodemographic Characteristics on CMS Hospital Compare Quality Ratings

  • Wenshuai Wan
  • C. Jason Liang
  • Richard DuszakJr.
  • Christoph I. Lee
Concise Research Reports


In July 2016, the Centers for Medicare & Medicaid Services (CMS) released “Hospital Compare” ratings for 3576 U.S. hospitals to help consumers compare hospitals’ quality of care, which was distilled into a single overall rating between 1 and 5 stars based on 57 process- and outcomes-based clinical measures.1,2 A recent publication found differences in overall ratings by characteristics including a hospital’s teaching status.3 Professional groups (e.g., the American Hospital Association) have expressed concern that the current ratings scheme unfairly penalizes teaching hospitals, especially those serving low-income and otherwise disadvantaged patient populations.4

Our objective was to build a statistical model that adjusted  for a more complete set of covariates than previous studies to analyze discrepancies in Hospital Compare ratings between teaching and non-teaching hospitals. Informed by previous findings, we attempted to more fully capture key aspects of an academic...


health services research quality assessment Medicare sociodemographic factors risk adjustment 


Funding Information

Wenshuai Wan, MD received funding during the research project from a Ruth L. Kirschstein National Research Service Award (T32).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


  1. 1.
    Centers for Medicare & Medicaid Services. CMS Releases First Ever Hospital Compare Star Ratings. 2015 Apr 16. Available at: Accessed 21 March 2018.
  2. 2.
    Centers for Medicare & Medicaid Services. First Release of the Overall Hospital Quality Star Rating on Hospital Compare. 2016 Jul 27. Available at: Accessed 21 March 2018.
  3. 3.
    DeLancey JO, Softcheck J, Chung JW. Associations Between Hospital Characteristics, Measure Reporting, and the Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings. JAMA. 2017;317(19):2015–2017.CrossRefGoogle Scholar
  4. 4.
    Pollack R. Statement on Centers for Medicare and Medicaid Services (CMS) overall hospital star ratings. 2016 Jul 27. Available at: Accessed 21 March 2018.
  5. 5.
    Fiscella K, Burstin HR, Nerenz DR. Quality measures and sociodemographic risk factors: to adjust or not to adjust. JAMA. 2014;312(24):2615–6.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Wenshuai Wan
    • 1
  • C. Jason Liang
    • 2
  • Richard DuszakJr.
    • 3
  • Christoph I. Lee
    • 4
    • 5
    • 6
  1. 1.Department of Radiology Hospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Biostatistics Research BranchNational Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesdaUSA
  3. 3.Department of Radiology and Imaging SciencesEmory University School of MedicineAtlantaUSA
  4. 4.Department of RadiologyUniversity of Washington School of MedicineSeattleUSA
  5. 5.Department of Health ServicesUniversity of Washington School of Public HealthSeattleUSA
  6. 6.Hutchinson Institute for Cancer Outcomes ResearchSeattleUSA

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