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WASHINGTON—The VA will no longer use a star ratings system to compare its 146 VA medical centers. Instead, the VA will make public measures such as wait times, quality of medical care and patient experience ratings available for each facility.
According to VA officials, the move will allow veterans to better compare VA facilities with other providers in their region and provide a more accurate view of the care they would receive at VA.
VA officials stressed that the star rating system was never intended as a tool for veterans to judge the quality of a VA facility. Rather it was an internal system to allow the department to compare VA facilities across the country.
An investigation by USA Today published in December 2016 revealed the existence of the rating system and noted where the lowest performing hospitals were located. The star ratings—with 1 being the lowest and 5 the highest—were based on myriad factors, including death and infection rates and wait times.
Bowing under public pressure, VA soon announced it would make the ratings public. Each year, updates to the rating system have made news, with stories detailing which hospitals had risen or fallen in their rankings and which were considered best and worst.
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VA leaders played their own part in raising the profile of the rating system through statements highlighting hospitals that had improved over their previous ranking. For example, following the release of the 2018 ratings update, VA put out a press release touting improvements with Secretary Robert Wilkie saying, “With closer monitoring and increased medical center leadership and support we have seen solid improvements at most of our facilities.”
At the same time, VA officials have long argued the system was a poor tool for veterans seeking care, since it did not compare VA facilities to other hospitals in the areas where veterans were seeking care. According to VA, the ability for veterans to compare VA with private hospitals has become even more important with the passing of the MISSION Act, which allows more of them to receive VA-reimbursed care from non-VA providers.
MISSION Act
“With the MISSION Act implemented this year, VA is more transparent with veterans than ever before, making VA the most transparent of any healthcare system in the country, possibly the world,” said VHA Chief Richard Stone, MD, in a statement in December. “Veterans need to be able to compare VA facilities with other local facilities where they live, not against other VA hospitals across the country. It doesn’t make sense for a VA Medical Center in Arkansas to be compared to one in Boston, as those are two entirely different geographies with unique medical demographics, staff availabilities, etc. There will always be standards used across the country, but direct comparisons are most meaningful in a local market to veterans making a decision about where to receive health care. Ultimately, the stars do not illuminate what is actually happening in our facilities, instead obscuring the reality on the ground.”
To replace the star ratings, Stone said that each VA facility’s homepage will have links taking veterans to https://www.accesstocare.va.gov/. There, they will be able to compare how their local VA facility ranks against other hospitals in the area, see how the facility fares in specific outpatient categories compared to other area clinics, find out wait times for the VA facility and see how satisfied other veterans have been with their access to care at the facility.
The information is drawn from VA data, as well as from the Centers for Medicare and Medicaid Services, National Committee for Quality Assurance, and the Agency for Healthcare Research and Quality, among others. Veterans will still be able to use the site to discover which VA facilities across the country rank worst and best things such as death, infections, surgical complications and other outcome measures.