JACKSON HOLE, WYO – St. John’s Medical Center (SJMC) finds itself at both ends of the spectrum this month with recent ratings and metrics out of Medicare and Medicaid Services. Which one to believe? Hospital officials are proud of more the comprehensive 5-star rating, and downplaying to a degree a lesser hit to the brand.
First, the good news. The Centers for Medicare & Medicaid Services (CMS) has just announced the update of its Overall Hospital Quality Star Ratings. Only 293 of the over 4,500 hospitals nationwide received the highest rating: five stars. St. John’s Medical Center is the only hospital in Wyoming to be recognized with this five-star rating.
“This achievement, one that we have been awarded for five consecutive ratings cycles, recognizes St. John’s focus on providing ever-improving quality care,” said St. John’s CEO Paul Beaupré, MD.
Beaupré noted that CMS has a complex and sometimes confusing system for evaluating and reimbursing providers for hospital quality.
“We hope that the quality rating—five stars for St. John’s—helps reduce some of the confusion by highlighting the overall quality of our care relative to other hospitals in the state and country,” Beaupré said. “I couldn’t be more proud of my team and our entire medical community for their contributions to this outstanding achievement.”
The five-star rating comes on the heels of another recent report that found the federal government had penalized nine Wyoming hospitals for high readmission rates, St. John’s among the highest with 2.82%—the most of any Wyoming hospital since penalties began in 2015.
The Casper Star-Tribune reported that the Kaiser Family Foundation’s Kaiser Health News says the federal Affordable Care Act allows Medicare to cut payments to the hospitals.
The hospitals penalized in Wyoming for excessive readmission rates were St. Johns Medical Center in Jackson, Mountain View Regional in Casper, Cheyenne Regional, Wyoming Medical Center in Casper, Campbell County Memorial Hospital in Gillette, Evanston Regional, SageWest Health Care in Riverton, Memorial Hospital of Sweetwater County and Ivinson Memorial Hospital in Laramie.
Overall, Kaiser says 800 hospitals were penalized across the country.
In response, SJMC spokesperson Karen Connelly said the CMS reimbursement process can be quite confusing for most, even hospital administration.
“For instance, we don’t know much about the peer groups we were compared to. During that same timeframe (2014-2018) that we received these positive results, we were also penalized with $70,000 in takebacks.”
The takeaway is CMS’ Overall Hospital Quality Star Ratings are a more comprehensive measure of how well a hospital is doing. The readmission reimbursement penalties are more subject to statistical anomalies.
“We take it seriously and we know we have some work to do primarily with two areas of readmissions—joint replacement and COPD (chronic obstructive pulmonary disease),” Connelly said. “We’ve put some programs in place since this data was collected and we believe we will see positive results moving forward.”
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