Medicare is considering assigning stars or some other easily understood symbol to hospitals so patients can more easily compare the quality of care at various institutions.

The ratings would appear on Medicare's Hospital Compare website and be based on many of the 100 quality measures the agency already publishes.

The proposal comes as Medicare confronts a paradox: Although the number of ways to measure hospital performance is increasing, those factors are becoming harder for patients to digest.

Hospital Compare publishes a wide variety of details about medical centers, including death rates, patient views about doctor communication, infection rates for colon surgery and hysterectomies, emergency room efficiency, and overuse of CT scans.

In its proposed rules for hospitals in the fiscal year starting Oct. 1, the Centers for Medicare & Medicaid Services asked for ideas about "how we may better display this information on the Hospital Compare Web site. One option we have considered is aggregating measures in a graphical display, such as star ratings."

Private groups such as Consumer Reports, the Leapfrog Group, and US News and World Report already issue hospital guides that boil down the disparate Medicare scores -- along with their own proprietary formulas -- to come up with numeric scores, letter grades, or rankings.

But even before it's formally proposed, the possibility of the government rating hospitals based on a star system is receiving less than heavenly reviews. In a letter to Medicare, the Association of American Medical Colleges said it "strongly opposes the use of a star rating system, which may make inappropriate distinctions for hospitals whose performance is not statistically different. A star rating system can also exaggerate minor performance differences on measures."

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