Date: October 27, 2021
The Centers for Medicare & Medicaid Services (CMS) recently released its 2021 Hospital Quality Star Ratings, which incorporate several changes to the methodology. This change in methodology was intended to address methodological concerns about the 2016 Hospital Quality Star Ratings and to include more Critical Access Hospitals (CAHs) in the rating system. The purpose of this study is to 1) compare the 2021 CMS Hospital Quality Star Rating results for rural and urban hospitals, 2) to compare the 2021 and 2016 CMS Hospital Quality Star Rating results for rural hospitals, and 3) to identify implications for the usefulness of the CMS Hospital Quality Star Ratings for rural hospitals.
Key findings from this study include the following:
- Rural hospitals were more likely to be unrated than urban (41.6% vs. 12.0%).
- There was a large increase in the percentage of unrated rural hospitals between 2016 and 2021 (34.3% to 41.6%).
- Almost all (89.4%) unrated rural hospitals are CAHs.
- Almost half (45%) of unrated rural hospitals are in the Midwest census region.
George H. Pink, PhD
North Carolina Rural Health Research and Policy Analysis Center
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