Effective this year, U.S. News & World Report will make adjustments to its methodologies used to determine its “Best Hospitals” and “Best Children’s Hospitals” rankings, the outlet announced this week.
The rankings, due out this summer, will assign more weight to clinical outcomes and other objective measures of quality, and less weight to the outlet’s opinion survey of physicians, said Ben Harder, managing editor and chief of health analysis at U.S. News, in a post on its website.
Changes to the “Best Hospitals” rankings come as a bevy of top academic institutions have publicly stated they will withdraw from the U.S. News medical school rankings.
Though the “Best Hospitals” rankings are inherently different, and separate from the medical school rankings — which involve participating institutions submitting data for consideration — U.S. News did cite objectivity in its latest announcement. “This shift reflects our ongoing effort to use more objective data in our hospital ranking methodologies,” Harder noted.
“Our decision was informed by discussions with numerous stakeholders, including hospital leaders and medical experts in diverse specialties,” he added. “While studies indicate that patients consider provider reputation when choosing where to receive care, medical professionals, whom we regularly consult with, generally agreed that subjective data should play a lesser role in determining the U.S. News hospital rankings.”
In an emailed statement provided to MedPage Today, Harder wrote, “Each year before rankings are released, we evaluate the methodology for “Best Children’s Hospitals” and “Best Hospitals” rankings, make appropriate changes and notify the hospitals of the changes. Publication dates for the 2023-2024 rankings were previously shared with hospitals and will not be affected by the methodology changes announced this week.”
As for specific changes, Harder detailed that outcome measures derived from federal data will account for 45% of the methodology in 11 of 12 adult specialty rankings, up from 37.5% last year, and will account for 30% in rehabilitation, up from 20% last year. Structural indicators of quality, such as the availability of key patient services, will account for 35% in all 12 adult specialties.
Additionally, in four adult specialty rankings — cardiology and heart surgery; neurology and neurosurgery; obstetrics and gynecology; and pulmonology and lung surgery — the weight assigned to expert opinion will be reduced to 12% from about 25%, Harder noted. In seven other specialties — cancer; diabetes and endocrinology; ear, nose and throat; gastroenterology & GI surgery; geriatrics; orthopedics; and urology — expert opinion will be reduced from 27.5% to 15%. In rehabilitation, expert opinion will be reduced from 50% to 30%.
For pediatric specialty rankings, Harder said that measures of best practices, as well as diversity, equity, and inclusion, will have greater weight this year than last year — increasing from 9.17% to 12%, and from 2% to 2.33%, respectively. Additionally, the weight of expert opinion will decrease from 8% to 5% in pediatric cardiology and heart surgery, and from 13% to 10% in all other pediatric specialties.
“Best Hospitals for Maternity Care” rankings, as well as those for 20 procedures and conditions, will remain unchanged because they have never factored in expert opinion, Harder explained.
He noted, however, that U.S. News would also be taking a closer look at how it assesses hospital performance in health equity.
Specifically, he said that U.S. News had received a “large volume of feedback” from hospital leaders, clinicians, researchers, and other stakeholders following the publication of an article in JAMA last fall that described its portfolio of health equity measures.
“In light of their input, we have decided to devote additional time to refining how we assess hospital performance in health equity,” Harder wrote. “While this work is ongoing, health equity measures will not be used in the adult “Best Hospitals” rankings published on August 1, 2023.”
As for the medical school rankings from U.S. News, those are likely due out in March, based on last year’s publishing schedule.