April 21, 2016

Andy Slavitt, Acting Administrator

Centers for Medicare & Medicaid Services
U.S. Department of Health & Human Services
7500 Security Boulevard
Baltimore, MD 21244

Dear Acting Administrator Slavitt:

The National Committee for Quality Assurance (NCQA) commends you for your thoughtful work in developing the Hospital Star Ratings and urges you to move forward as quickly as possible with implementation. The Star Ratings will display easy-to-understand hospital grades based on 60 quality measures, and allow those who want more details to drill down into each of the individual measures.They are a powerful, much needed tool for driving improvement and helping stakeholders – especially consumers –understand and make informed choices based on quality.

We were therefore disappointed to learn of the delayed implementation to address concerns raised by some hospital. We appreciate the need to take their concerns into consideration, but stress that other stakeholders’ need for Star Ratings, and differences of opinion with some hospitals suggestions, also must be considered.

We and many others do not agree with suggestions to risk adjust the measures for patient sociodemographic factors as this would mask, rather than address, important disparities in care. Lower sociodemographic status patient populations may be associated with poorer performance, but many plans and providers serving such populations nonetheless achieve high performance. We should be working to help all providers replicate that success rather than unfairly locking in lower expectations for the very populations that most need better quality health care.

We therefore urge you to promptly post the Star Ratings so all stakeholders can begin to benefit from them. We again commend you for your hard work and look forward to the improved quality and informed patient choices that they will promote. Thank you and please contact Director of Federal Affairs Paul Cotton at (202) 955 5162 or cotton@ncqa.org with any questions.


Margaret E. O’Kane
President & CEO