The hospital system rating is based on basic concepts of efficiency and patient care.  "Measures used to calculate these ratings (such as rates for mortality, readmission and complications) are often adjusted for clinical risk factors, including age and comorbid conditions.“  A key factor that is left out of these ratings are socioeconomic factors, race, and even language.

For example "the proportion of a hospital’s patients who are admitted through the emergency department and the percentage of patients whose primary language is not English” are useful pieces of information for an increasingly diverse nation.  In a stunning revelation, hospitals that except more patients through Medicare and emergency situations are more likely to receive lower star ratings.  

“The Medicare Payment Advisory Commission noted that among the CMS one-star hospitals, an average of 78 percent of admissions were admitted through the emergency department, while at five-star hospitals, only 36 percent of admissions were admitted through the department.”  In addition “among the one-star hospitals rated by CMS, 36 percent of patient days were paid through Medicaid, versus 17 percent among five-star hospitals." 

Hospitals are currently rated lower for keeping with the mantra of helping all patients at all times.  An added criteria for diversity is needed especially in today’s climate.  

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