CMS Hospice Star Ratings

Amanda C. Chen and David C. Grabowski’s article (June 2025) finds that many hospices do not receive Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey star ratings and that the proportion of hospices without star ratings has increased. In part, this finding reflects the proliferation of new hospices in the market, with almost 1,200 hospices entering during the study period, rather than a limitation in the Centers for Medicare and Medicaid Services (CMS) program. As the authors note, very small and new hospices are exempt from CAHPS Hospice Survey data collection. This ensures that these hospices can focus their limited resources on patient care. Moreover, as a result of small sample sizes or short time in operation, it is impossible to calculate reliable measure scores or star ratings for these hospices, and any such ratings would potentially mislead users instead of informing them.