- U.S. News & World Report announced methodology updates for its 2018-19 Best Hospital rankings, due to publish on Aug. 14.
- The Best Hospitals program encompasses more than two dozen sets of ratings and rankings covering surgical procedures, medical conditions and complex specialty care. It also ranks best hospitals by region and highlights a 20-hospital Honor Roll. Hospitals are ranked using an analytical methodology developed by U.S. News and data services firm RTI International.
- The methodology changes include adding more outcome and patient experience measures as well as tweaks to how risk-adjusted mortality rates are used.
With the advent of online ratings and reviews, and more consumers shopping for healthcare, providers look to these designations to boost brand loyalty and attract new customers. But hospitals also worry about assessments of their quality and performance being reduced to a simple grade or star.
In October, Saint Anthony Hospital in Chicago sued The Leapfrog Group, claiming the organization knowingly used inaccurate information to downgrade its safety grade from an A to a C. The safety net hospital said it repeatedly pressed Leapfrog to correct the score before the report’s release date, and said the group’s failure to respond amounted to defamation. Leapfrog eventually took Saint Anthony off the website. The lawsuit has since been dismissed.
In another case, an Ohio plastic surgeon filed a defamation lawsuit after a patient wrote anonymous online reviews criticizing the doctor’s work.
In December, CMS updated the formula for the star ratings on its Hospital Compare website to allow for broader distribution of the ratings. The agency said the new scheme is more reliable and will provide more stable estimates.
U.S. News’ methodology includes several changes from the 2017-18 edition. For starters, the analyses include Medicare claims containing ICD-10 codes, which replaced ICD-9 last fall. “To account for potential residual differences in billing patterns between the ICD-9 and ICD-10 eras, a dichotomous variable for pre- vs. post-ICD-transition was included in risk-adjustment models for all cohorts and outcomes,” the publication said.
In its specialty rankings, inpatients transferred from one hospital to another are no longer factored into the receiving facility’s risk-adjusted mortality rate. Also, risk-adjusted mortality rates are now based on a one-to-10 survival score, with one through five indicating a higher-than-expected mortality rate and six through 10 a lower-than-expected rate.
This year’s analyses also include more outcome measures to emphasize patient outcomes over hospital characteristics. For example, in colon cancer surgery, designation as a National Cancer Institute Cancer Center replaces Nurse Magnet as a structural measure, and a new process measure for hip and knee replacements rewards hospitals with relatively low rates of non-autologous blood transfusions.
The methodology also includes new measures on readmission prevention and patient experience.