The Kansas City area now has three five-star hospitals, according to Medicare.
Providence Medical Center in Kansas City, Kan., Saint Luke's Hospital in Kansas City, Mo., and Saint Luke's South in Overland Park all got five stars in the latest ratings released by the Centers for Medicare and Medicaid Services. They were among 337 hospitals nationwide to get that designation out of about 4,800 rated.
But some say the government rating system is still unfairly penalizing hospitals with low-income patients.
The ratings are available on Medicare's Hospital Compare website. They've have been controversial since 2016, when they were first released over hospital industry objections that they glossed over key differences between hospitals and the populations they serve.
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The government collects data for the ratings from a variety of sources, including Medicare claims. Hospitals are measured on patient satisfaction surveys, the timeliness and effectiveness of care in eight different common conditions, rates of surgical complications, infections and death, unplanned hospital re-admissions, proper and safe use of medical imaging tests and value of care for the price.
Even the agency that collects the data and creates the ratings says they're not a complete picture of quality of care, and consumers should use them in combination with other information, like referrals from a primary care physician, when choosing a hospital.
But Melinda Estes, president and CEO of Saint Luke's Health System, says the five-star rating is still reflective of quality care.
"Saint Luke's is committed to providing high-quality care to our patients, so we are honored to be recognized among the nation's best hospitals for quality, safety and patient satisfaction," she said.
Saint Luke's Health is a locally based non-profit hospital group affiliated with the Episcopal church.
Providence, in western Wyandotte County, is one of four area hospitals owned by Prime Healthcare Services, a California-based for-profit company that is the fifth-largest hospital system in the United States.
The University of Kansas Hospital, the area's largest, received four stars, an improvement over last year.
Rita Numerof, a health care consultant in St. Louis, said the ratings are not perfect, but they're better than nothing, which is basically what consumers previously had to go on when trying to judge hospital quality.
“We’re a long way from where we need to be, but I think this is a really good mile post along that journey,” Numerof said.
Numerof said patients can use the star ratings as a general quality guide, then seek out more information about which hospitals excel at the type of specific care each patient needs, whether that's chemotherapy or knee replacements. She said Consumer Reports is one source of that type of information.
Before the new ratings were released, Shawnee Mission Medical Center was the only facility in the Kansas City area with five stars — a designation that featured prominently in the hospital's marketing.
Shawnee Mission Medical Center dropped to four stars. Shawnee Mission Health spokeswoman Morgan Shandler said the hospital is adjusting to changes to in the methodology used to determine the ratings.
"While we are disappointed about the drop in our score, we recognize this as an opportunity to improve, and are actively working as an organization on making modifications in some areas to again have a five-star rating,” Shandler said.
Tim Williamson, the vice president of quality and safety at the University of Kansas Health System, said there were some tweaks to the methodology, but not "overwhelming changes."
"The underlying concerns about the methodology really haven't been relieved at all," Williamson said.
KU Hospital improved from three stars to four in the latest ratings. But Williamson said he still thinks academic medical centers and safety net hospitals aren't getting a fair shake because their patients face health complications and socioeconomic hurdles that the government's measures don't account for.
The latest tweaks actually helped a higher percentage of suburban community hospitals move up in the ratings, he said.
Williamson also said the ratings aren't particularly useful for judging the current state of a hospital because it takes more than a year for the government to collect and analyze the data. He said KU's upgrade reflects improvements made several years ago.
“Even though we're happy that we're improved and it reflects some of that work, we still think there are substantial limitations to how they calculate this," Williamson said. "And I would be saying exactly the same thing if we went from a four to a five."
KU and Truman Medical Center were among hundreds of hospitals nationwide that are absorbing a 1 percent reduction in Medicare payments based on higher-than-average rates of complications and infections.
That penalty is also controversial because it falls disproportionately on certain types of hospitals.
Truman, which is both an academic medical center and an urban safety-net hospital that treats uninsured Jackson County residents, dropped from two stars to one in the latest ratings.
Jeffrey Hackman, Truman's chief medical information officer and medical director for quality, said the American Hospital Association and other national organizations are pushing the government to adjust its measures to better account for differences in patient demographics.
He noted that Truman's Lakewood hospital, which is located in a more affluent part of Kansas City, got three stars.
"The CMS system needs to be modified to account for factors like socioeconomic challenges of patients, complexity of care, percentage of immuno-compromised patients, and other complicating factors," Hackman said. "Safety and quality have been and will continue to be Truman Medical Centers’ two highest priorities, in line with our goal to provide high-quality care for all of our patients, without exception."
Numerof said hospitals can't be held responsible for societal inequality. But they best get used to the federal ratings and respond to them.
"These ratings have not gone away," Numerof said. "They've gotten better (and) they're more public. They are not where they need to be. I am still a critic of them (but) I think they need to stay and they need to get continuously refined.
"They should put pressure on all health care delivery organizations to continuously improve the quality of the work they do and the outcomes they're responsible for achieving."
Medicare Hospital Compare ratings for hospitals within 25 miles of downtown Kansas City:
- Providence Medical Center - 5
- Saint Luke’s - 5
- Saint Luke’s South - 5
Saint Luke’s East - 4
- Saint Luke’s North - 4
Shawnee Mission Medical Center - 4
- St. Joseph Medical Center - 4
- St. Mary’s Medical Center - 4
University of Kansas Hospital - 4
Lee’s Summit Medical Center - 3
Liberty Hospital - 3
Menorah Medical Center - 3
North Kansas City Hospital - 3
Overland Park Regional - 3
- Truman Medical Center - Lakewood - 3
- Research Medical Center - 2
- Centerpoint Medical Center - 1
- Truman Medical Center- 1