Not All Stars are Created Equal

Added on Sep 1, 2015

At its core, transparency of patient experience data empowers consumers to make informed decisions about where to seek care and from whom. It also raises provider awareness of performance gaps, informs improvement strategies and promotes physician accountability.
To achieve these goals, health systems must adopt reliable and consistent reporting protocols that accurately reflect the data being reported. This can best be accomplished through the development of a standardized star rating system that aligns with industry norms and expectations.

For example, an approach that converts individual survey responses into linear scores on a 0- to 100-point scale and converts the adjusted ratings to a 0- to 5-star scale, similar to the star-ranking system used by CMS for its Physician Compare web site, allows consumers to understand physician performance across multiple measures using a consistent ruler. 

Variation across rating methodologies, on the other hand, can misrepresent the consumer experience and impede progress toward the delivery of patient-centered care. 

Approaches that deviate from the 0- to 100-point linearization, for instance, may artificially inflate scores by creating a false floor. Additionally, such approaches can lead to clustering of results at the top of the score range, which reduces differentiation among individual physicians and limits the usefulness of the information to patients. In the long run, artificially boosting provider performance will erode patient trust, damage provider credibility and put the integrity of the health system brand at risk.
Similarly, rating methodologies that allow for the suppression of unfavorable comments contradict the spirit and objective of performance transparency. They diminish the value of the information being shared and reduce the likelihood that it will improve quality, promote greater accountability or enhance the patient experience. Without such selling points, public reporting of patient experience data doesn’t have much going for it.

When a health system decides to embrace transparency of performance outcomes, it is engaging in an unwritten contract with the patients and community it serves to provide honest and accurate information without bias to support decision-making. Through the same unwritten contract, the system is making a commitment to its physicians that the ratings being publically reported will be derived from a process that is rigorous enough to ensure the completeness, integrity and statistical validity of the data being shared. 
The adoption of an industry-wide standard for ranking physician performance—one in which all stars actually are created equal—and a unified standard for reporting patient comments would minimize the opportunity for the spread of misinformation through tactics built on “selective” transparency. It would also level the playing field for consumers and providers alike.

"As more and more consumers turn to online physician ratings when selecting a provider, we have a responsibility to ensure that the ratings available are objective, standardized evaluations of the patient experience that patients can trust," according to Press Ganey CEO Patrick T. Ryan.
To this end, it is imperative that individual health systems and the industry as a whole take steps to ensure each and every star sheds the same light.