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Each fall, the CMS announces the next year’s hospital star-ratings algorithms. Analysts race to criticize or support the changes (mostly criticize), while marketing managers at one- and two-star hospitals go into overdrive to highlight the system’s unfairness. January starts a new season of gamesmanship as hospitals adapt to the new scoring rubric, seeking to polish their performance in the ratings.All of this activity, however, has little to no impact on the health outcomes that actually matter to patients.