Beware the “Star System”

The “Star System” for Patients

The facility left much to be desired.



It smelled of urine, the floors were dirty, and there wasn’t a nurse to be found.



And when I did find one, what I saw astonished me.



She had a company scrub top on—promoting the facility’s five-star rating.



That’s when I began to suspect something was up.



And I really started to look around.



The government uses a star rating system as a shorthand for the “quality” of a healthcare provider.



It gives every healthcare provider who accepts government money a “quality” rating of one to five stars, five being the best.



The idea is to let you, the patient, know who’s “best.”



There are star ratings for nursing homes and insurance plans online—and soon you’ll be able to find one for your doctor.



You can find those star ratings on the internet, usually through the website.



They’re easy to understand, patients like them, and they work.



People really do choose their care providers based on those stars.



The problem is, what the government thinks quality looks like and what quality actually is may be two different things.



And these star ratings have become such a valuable marketing tool, that they’re a magnet for fraud.



Medicare Advantage insurers, for example, have a fraud problem so bad that the government has begun to redo their whole quality rating system.



Even if they’re not abused, there’s no evidence that the things that go into the star ratings have anything to do with better care for you — the patient.



The star ratings for doctors will include a heavy dose of how much money the doctor saves Medicare.



As a patient, I really don’t care about that. I care about whether or not the doc will take good care of me.



Yet that’s what a “five-star” doctor will be—one who practices most cost-effective for the government.



So how can you use these messed up star ratings to your benefit?



Use the pass/fail method.



Stay away from low star providers—the ones and the twos. Treat them as fails. They’re off the table.



Treat providers with “three-star” or higher ratings as ones who “pass.”  Put them on the list for more consideration and then look at them closely from there.



Remember, a three-star provider is not necessarily worse than a five star one. They may simply have decided not to play the games needed to get a higher rating.



Because that’s all it is—a game.



The facility I found myself in was indeed playing around with the data it was giving the government to get its rating.



I vowed never again to impressed by ratings.



Now that you know that the rules are kinda fixed, you can play the game to your personal benefit.



Use the star ratings to eliminate the losers.



Then ask someone you trust to help you pick a winner



And then go and win yourself.



It’ll be well worth it.