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Published on February 18, 2020

Why you should care that Medicare gave your hospital 5 stars

CMS 5 Star

Cape Cod Hospital and Falmouth Hospital each recently received 5-star ratings from the Centers for Medicare and Medicaid Services (CMS), which is the top rating given out by the federal healthcare agency. It is the third consecutive year Cape Cod Hospital (CCH) has received the top rating and the first year for Falmouth Hospital (FH).

But what does that mean for the average person on Cape Cod?

Most importantly, if you or a loved one are a patient at either hospital, you have a better chance of surviving your illness or injury, and a lower chance of being readmitted to the hospital due to a post-hospital complication than at most other hospitals in the country. You also have a higher chance of avoiding in-hospital complications.

CCH and FH were among just 407 hospitals nationwide to earn the 5-star rating. More than 4,500 hospitals around the country were assessed by CMS in the recent ratings review.

“It’s a pretty big deal,” said Kevin Mulroy, DO, chief quality officer for Cape Cod Healthcare, the hospitals’ parent organization. “This is rarefied air.”

The CMS Hospital Compare ratings system was created to help healthcare consumers choose the best hospital for their care. The ratings summarize a variety of measures across seven areas of quality, the most important being mortality, safety and readmission rates, said Dr. Mulroy. Mortality rates at CCH and FH consistently hover around 60 to 70 percent of what would be expected.

“Our goal is always to have zero complications, of course, and we’re on our way,” he said. “Our numbers are going in the right direction.”

CMS assigns weight to each of the measures it reviews, and the seven groups of measures, in order of statistical weight are:

  • Mortality
  • Readmissions
  • Safety of care
  • Patient experience
  • Effectiveness of care
  • Timeliness of care
  • Efficient use of medical imaging.

CCH and FH also currently rated ‘A’ (the top score) by another independent review agency, Leapfrog, which looks at similar measures.

The successful reviews from these agencies reflects the concentration on the refinement of process improvement at the hospitals over the last decade or so. Process improvement focuses on ways to maintain repeatable and sustainable processes around patient care, and Dr. Mulroy said CCHC CEO Michael Lauf has emphasized its importance since he took over as CEO in 2010.

“We strive to embrace the concepts of process improvement, and that reflects in the scores,” Dr. Mulroy said.

Lauf praised the physicians and staff for the positive outcomes the hospitals are seeing.

“Our physicians, nurses, technicians, quality control staff, environmental services and others at FH and CCH have worked tirelessly to build a patient-centered culture focused on zero harm and high reliability,” he said.

In addition to the CMS 5-star ratings and the Leapfrog ‘A’ achievement, both hospitals each also had successful reviews by The Joint Commission within the last year. The Joint Commission does extensive on-site reviews at hospitals, focusing on the quality of patient care.