- U.S. News & World Report on Tuesday released its 2018-19 rankings of best hospitals in the country, with the Mayo Clinic earning the No. 1 spot for the third year in a row.
- Three of the other top five hospitals also held onto last year's ranking: Cleveland Clinic (2), Johns Hopkins Hospital (3) and Massachusetts General Hospital (4). University of Michigan Hospitals-Michigan Medicine bumped UCSF Medical Center to round out the top five on the Best Hospitals Honor Roll.
- The ranking compares more than 4,500 hospitals across 16 specialties and nine procedures and conditions.
The publisher updated its metrics for this year's rankings, including more of a focus on patient outcomes. For one thing, the analyses include Medicare claims containing ICD-10 codes, which replaced ICD-9 last fall. In its specialty rankings, inpatients transferred from one hospital to another are no longer factored into the receiving facility's risk-adjusted mortality rate, and those rates are not based on a one-to-10 survival score.
The new methodology also includes more outcome measures to stress patient outcomes over hospital characteristics. For example, a new process measure for hip and knee replacements rewards hospitals with relatively low rates of nonautologous blood transfusions.
This year, 158 hospitals were nationally ranked in at least one specialty, up from 152 in 2017-18. However, just 29 received a high rating in all nine procedures and conditions, compared with 48 a year ago.
Jefferson Health-Thomas Jefferson University Hospitals in Philadelphia took first place in both the cancer and cardiology and heart surgery categories, while Yale New Haven Hospital ranked best for diabetes and endocrinology. The No. 1 hospital for orthopedics is Penn State Health Milton S. Hershey Medical Center.
Rankings by third-party organizations such as U.S. News are important as patients become more proactive about shopping for healthcare, but they can also can also be misleading or draw unfair comparisons.
Last summer, the American Hospital Association wrote to CMS Administrator Seema Verma urging her to suspend the agency's star rating system on grounds that it oversimplifies complex data and penalizes teaching hospitals and centers with higher volumes of poorer patients. The agency has repeatedly delayed updating star ratings as it tries to respond to provider concerns. In the most recent setback, CMS delayed an update planned for July, citing a need for more time to assess the effect of proposed changes to methodology on ratings.
Unhappy with online rankings, some providers have turned to the courts. Chicago-based Saint Anthony Hospital sued Leapfrog after the group downgraded its safety rating from A to C last year. The nonprofit hospital claimed Leapfrog used incorrect information on electronic prescriptions to determine the grade and said a C would "irreparably degrade" its public image.
U.S. News produced the 2018-19 rankings in conjunction with RTI International and Fidelity.