CASPER — Wyoming’s two largest hospitals were both rated average by the Centers for Medicare and Medicaid Services earlier this year, with Jackson’s St. John’s receiving the only five-star rating from the federal government’s Hospital Compare website.
The CMS ratings were updated in late February for the first time in more than a year, when the government announced it would tweak the way it calculated the ratings. In all, CMS rated more than 4,500 facilities nationwide, giving three-star ratings to more than 1,200. In Wyoming, 18 facilities were rated. Two received two stars, nine — including Casper’s Wyoming Medical Center — were given three stars, and six were rated at four.
The ratings track a broad range of factors, from complications to payments and values of care.
On payments, for instance, WMC was at or below the national average for four types of services — heart attack, heart failure, pneumonia, and hip and knee replacements.
Indeed, WMC was generally rated as about the national average across the board by CMS. It tipped above or below that benchmark in a few areas, though. For instance, the agency noted that the hospital had a worse national death rate for heart failure patients, but it was better than both the Wyoming and national average for expecting mothers whose deliveries were scheduled too early and for the rate of hospital employees who were vaccinated.
The only category where the hospital consistently lagged behind its state and national peers was in patient satisfaction. It was given lower scores on eight of the 10 questions patients were asked, which included prompts about bathroom cleanliness, staff communication and how the patient rated their hospital experience from one to 10.
Hospital spokeswoman Mandy Cepeda said the facility had no comment on the ratings.
Three-star Cheyenne Regional, too, generally hovered around the national average but was consistently below state and U.S. averages for patient satisfaction. It outperformed its peers for sepsis treatment and colonoscopy follow-up recommendations, but performed more poorly on preventable blood clots and potential overuse of CT scans.
In a statement, CRMC’s chief medical officer, Dr. Jeffrey Chapman, broadly praised the hospital’s efforts, highlighting the hospital’s emergency care in particular.
While the state’s two largest hospitals sat firmly in the middle, Jackson’s St. John’s was one of the fewer than 300 hospitals nationwide that topped the pack. It was rated above the national average for safety, patient experience and timeliness of care and met the average in the other areas. A message left for the hospital earlier this week was not returned.
No Wyoming hospital received a one-star rating, though Riverton’s SageWest and Wheatland’s Platte County Memorial both received two stars. Platte County’s rating may partially be explained by a dearth of data — across seven indicators, CMS couldn’t compare it on four because information from the hospital wasn’t available. On the three areas where there was enough data to compare the facility to its peers — mortality, readmission rates and effectiveness of care — it was below average for readmission and average for the other two.
SageWest, meanwhile, had sufficient data for all seven indicators. It was below average on just two — efficient use of imaging and patient experience — and actually topped the national average in readmission rates and timeliness of care. A deeper dive into the data shows that it was consistently dinged by patient surveys. It also performed remarkably poorly on patients who received colonoscopy follow-up recommendations — just 7 percent, compared to a state average of 59 percent and a national average of 88 percent.
The hospital’s positive emergency department ratings were noted, with just a 26 minute median wait time.
“We are disappointed by the 2-star rating that SageWest Health Care has received through the Centers for Medicare and Medicaid Services (CMS) Overall Hospital Quality Star Ratings program,” hospital spokeswoman Lindsey Anderson said in a statement, “and anticipate a higher ranking when more recent quality improvement efforts and resulting progress are factored into the assessment.”
Anderson also noted that SageWest was recently given an A safety grade by health care group Leapfrog. Cheyenne Regional and Ivinson Memorial Hospital in Laramie both received Ds on that report card, most recently released in fall 2018, while WMC received a C for the seventh consecutive time.
The data used for these latest ratings by CMS is old — from 2017 or 2018. Some hospitals have been critical of the ratings for not taking into account the different services of the facilities as well. Many of the hospitals in Wyoming, for instance, don’t offer the breadth of services that Wyoming Medical Center or Cheyenne Regional provide, for instance.
Eric Boley, the president of the Wyoming Hospital Association, said the ratings are better than they were previously but are “still not perfect.”
“I think CMS has been working on them,” he said earlier this week. “The first time they rolled them out, they weren’t ready. ... I think CMS is trying to make adjustments to it to make it more realistic or give a truer picture, but I still think there are some improvements that need to be made. I think we’ll continue to see CMS work on that until they have a really good mechanism and good tool to use to compare hospitals.”
Such criticism — that a one-size-fits-all approach doesn’t work — is common of attempts to rate hospitals. But defenders say it’s imperative to judge the facilities in order to give consumers options — which in turn can affect prices.
In a statement accompanying the release of the new ratings in February, CMS wrote that the ratings were needed to “lower costs and improve quality.”
“Consumers and patients point to Hospital Compare and the Star Ratings as important resources and rely on the latest data,” the agency said. “Many hospitals rely on these ratings to identify areas for improvement.”
Wyoming hospital ratings as determined by the Centers for Medicare and Medicaid Services:
St. John’s Medical Center, Jackson
Campbell County Memorial Hospital, Gillette
Cody Regional Hospital
Memorial Hospital of Converse County, Douglas
Memorial Hospital of Sweetwater County, Rock Springs
Powell Valley Hospital
Cheyenne Regional Medical Center
Community Hospital, Torrington
Evanston Regional Hospital
Hot Springs County Memorial Hospital, Thermopolis
Ivinson Memorial Hospital, Laramie
North Big Horn Hospital District, Lovell
Star Valley Medical Center, Afton
Washakie Medical Center, Worland
Wyoming Medical Center, Casper
Platte County Memorial Hospital, Wheatland
SageWest Health, Riverton