CMS centers patient safety in Hospital Star Ratings methods

As part of the 2026 Hospital Outpatient Prospective Payment System (OPPS) final rule released late last week, the Centers for Medicare and Medicaid Services has issued an update to its Hospital Star Ratings that emphasizes patient safety.

Starting this year, hospitals that don't perform well in patient safety measures cannot achieve a 5-star rating. The agency also outlined how bad performance in patient safety could affect star ratings in future years.

This announcement comes as part of the so called Make America Health Again agenda. According to CMS, adjusting the Hospital Star Ratings calculations will emphasize factors linked to patient well-being and outcomes.

As part of the 2026 OPPS final rule, CMS updated the Hospital Star Rating system to dictate that hospitals performing in the lowest quartile for the Safety of Care measure group cannot receive a 5-star rating, regardless of good performance in other measure groups.

In the future, CMS plans to downgrade any hospital performing in the lowest quartile for patient safety measure groups by 1 star. So, if a hospital performing in the lowest quartile for patient safety would otherwise earn a 4-star rating, they'd actually receive a 3-star rating.

As part of the OPPS, the agency also added quality reporting measures related to emergency department wait times.

But perhaps more glaring are the quality measures CMS has removed, including ones related to health equity. This comes as data shows even top hospitals have serious racial health disparities in patient safety. Without data about those health disparities, hospitals don't have the ability to improve the health and well-being of patients CMS insists it wants to promote.

Sara Heath has reported news related to patient engagement and health equity since 2015.