Rating Process

Evaulation Criteria

Domain	Examples of Criteria	Strength and Weaknesses Comparison of the Ratings Systems
Potential for Misclassification	Use of known measures that are flawed Hospitals examined (numbers and type) Risk Adjustment Composite Methodology Methodological Approach Audit Mechanism	.PDF
Importance/Impact	Unique features that resonate with patients, referring physicians, and hospitals	.PDF
Scientific Accepability	Balanced Measurement Hospitals examined (numbers and type) Distribution/assigment of hospital grades/stars Use of available measures Use of unique data Specific methodological concerns Stability of rankings over time Audit mechanism	.PDF
Iterative Improvement	Response to stakeholder feedback and scientific advances in measurement science Review of methods prior to release Peer review of methods Expert panel level of involvement	.PDF
Transparency	Detailed methods report available (transparency) Clear rationale for methodological decisions Data availability (replicability) Financial conflicts and details regarding how ratings are monetized	.PDF
Usability	Ease of overall use Ability to compare hospitals easily Attention to varying health literacy and numeracy	.PDF
Audit	Type and extent of data validity audits performed	.PDF
Updates	Notable changes made by rating systems since our grading process	.PDF

	Composite Description	Data Sources
	Composite score star rating (1 to 5 stars)	CMS claims, NHSN, HCAHPS, CMS reporting system (CASPER), Joint Commission, CMS Abstraction and Reporting Tool, CMS Clinical Data Warehouse
	Distinguished Hospital Award for Clinical Excellence (DHACE) and America's 50 and 100 Best Hospitals Award	CMS inpatient claims, All-payer state data for ratings in Obstetrics/Gynecology, Bariatric Surgery, and Appendectomy
	Hospital Safety Grade: Composite letter safety grade Top Hospitals: Highest performing hospitals on the Leapfrog Hospital Survey	Hospital Safety Grade: Leapfrog Hospital Survey, CMS measures publicly reported on Hospital Compare (e.g. AHRQ PSIs, NHSN HAIs, HACs, HCAHPS), AHA Annual Survey and Information Technology Supplement Top Hospitals: Leapfrog Hospital Survey
	National 'Honor Roll' and 'Best Hospitals' (including 16 specialties and 9 procedures / conditions)	CMS inpatient claims, AHA Annual Survey, Hospital Compare for HCAHPS, public websites (STS, ACC, Magnet), Proprietary hospital reputation survey