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Majority Of Florida's Hospitals Score Below Average, Report Says

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Kaiser Health News
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Mayo Clinic in Jacksonville and Sarasota Memorial are the only two hospitals in Florida to receive the top score – five stars – for overall quality in a new federal rating system released on Wednesday.

Eighteen hospitals in the state were awarded four stars, and 76 were rated average.

That means more than three times as many Florida hospitals scored below average as rated above average, a Health News Florida analysis shows. Less than 12 percent were judged above-average, while nearly 44 percent were rated below-average.

If this were a report card, 61 would have gotten a “D” and 13 an “F.” Miami-Dade had three hospitals that received just one star and both Hillsborough and Palm Beach counties had two in the lowest tier.

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The Centers for Medicare and Medicaid Services based its star ratings on 64 individual measures that are published on its Hospital Compare website, including death and infection rates and patient reviews. Medicare officials noted that specialized and “cutting-edge care,” such as the latest techniques to battle cancer, are not reflected in the ratings.

Florida’s unhappy results were a reflection of the national ratings. The hospital industry, which has been pressing the Obama administration and Congress to block the ratings, argues they punish facilities that tackle the toughest cases.

“We are especially troubled that the current ratings scheme unfairly penalizes teaching hospitals and those serving higher numbers of the poor,” said Rick Pollack, president of the American Hospital Association.

Indeed, a preliminary analysis Medicare released last week found hospitals that treated large numbers of low-income patients tended to do worse, as did teaching hospitals. That showed up in South Florida, where one-star ratings went to the University of Miami Hospital and to Jackson Memorial, which handles the lion’s share of  charity care.

UF Health Jacksonville also received a one-star rating.

Despite the protests and the preliminary analysis, CMS held firm, saying that consumers need a simple and objective way to gauge quality. A similar rating system has been useful to consumers and patients in other medical facilities, such as nursing homes and dialysis centers, the agency said in a statement.

Those ratings have shown, Medicare said, “that publicly available data drives improvement, better reporting, and more open access to quality information for our Medicare beneficiaries.”

Just 102 U.S. hospitals received the top rating of five stars, and few are those considered as the nation’s best by private ratings sources such as U.S. News & World Report or viewed as the most elite within the medical profession.

Medicare awarded five stars to relatively obscure hospitals and a notable number of hospitals that specialized in just a few types of surgery, such as knee replacements. There were more five-star hospitals in Lincoln, Neb., and La Jolla, Calif., than in New York City or Boston.

Medicare awarded the lowest rating of one star to 129 hospitals, including Florida’s 13. Five hospitals in Washington, D.C., received just one star, including George Washington University Hospital and MedStar Georgetown University Hospital, both of which teach medical residents. Nine hospitals in Brooklyn, four hospitals in Las Vegas and three hospitals in Miami received only one star.

Some premiere medical centers received the second highest rating of four stars, including Stanford Health Care in California, Massachusetts General Hospital in Boston, Duke University Hospital in Durham, N.C., New York-Presbyterian Hospital and NYU Langone Medical Center in Manhattan, the Cleveland Clinic in Ohio, and Penn Presbyterian Medical Center in Philadelphia. In total, 927 hospitals received four stars.

Medicare gave its below average score of two-star ratings to 707 hospitals. They included the University of Virginia Medical Center in Charlottesville, Beth Israel Medical Center in Manhattan, North Shore University Hospital (now known as Northwell Health) in Manhasset, N.Y., Barnes-Jewish Hospital in St. Louis, Tufts Medical Center in Boston and MedStar Washington Hospital Center in D.C. Geisinger Medical Center in Danville, Pa., which is a favorite example for national health policy experts of a quality hospital, also received two stars.

Nearly half the hospitals — 1,752 — received an average rating of three stars. Another 1,042 hospitals were not rated, including 15 in Florida.

Health News Florida special correspondent Carol Gentry contributed to this report.