Then on July 7, the AHA, along with the Association of American Medical Colleges, America’s Essential Hospitals and the Federation of American Hospitals wrote to CMS Deputy Administrator for Innovation and Quality Dr. Patrick Conway, stating that since the March letter, “The agency provided additional information on how it calculates and assigns star ratings, but far too little information on whether the methodology gives a fair and accurate appraisal of the true quality of care provided in America’s hospitals ... The very fact that some of the nation’s best known hospitals with the highest of ratings on other assessments and that serve large numbers of low-income and complex patients are slated to receive a small number of stars from CMS should make one question the validity and soundness of the methodology.”

For example, CNBC reported that almost all institutions ranked at the top of U.S. News & World Reports “Best Hospital” list did not get 5 stars from the CMS Hospital Compare, including number one rated Massachusetts General Hospital.

In response to the CMS ranking, Mass General's Dr. Elizabeth Mort told CNBC, "I wouldn't hang my hat on this score, one way or the other."

"We're used to getting these different rankings," the senior vice president for quality and safety at the hospital advised. "I'm not in the least surprised that in one we will get the highest-possible rating, and in one we will not ... these methods for the CMS star ratings are vastly different from the methods used by U.S. News."

She also called the government's measurement methodology “significantly flawed," singling out its reliance on 30-day post-discharge "readmission rate," as a particular problem. "It's probably not a very good measure of hospital quality," she said.

University of Pittsburgh Medical Center, which is ranked 14 by U.S. News, earned just a two-star rating from Hospital Compare.

Its spokeswoman Wendy Zellner blasted the CMS methodology in an email, telling CNBC, "UPMC is a 20-plus hospital integrated health system that typically cares for the sickest of the sick across western Pennsylvania. Ten of our 13 hospitals rated by CMS rank at three stars or higher."

"That said, UPMC and many leading academic medical centers across the country have raised concerns about the questionable methodology used in this process, which does not appropriately adjust for patient complexity and socio-economic status," she noted, adding that "this has led to low ratings for many prominent hospitals that provide excellent care.”

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