U.S. News updates best hospitals methodology for specialty rankings

By | June 26, 2019

Dive Brief:

  • U.S. News & World Report is updating its methodology for ranking the country’s best hospitals, with the changes set to take effect when the new list is released July 30.
  • One measure being added for the assessment of specialty hospitals is discharge of patients to the home, in line with previously announced additions that focus on patient experience, such as the CMS’ Hospitals Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.
  • The publication is also making changes to its risk-adjustment methodology for the hospital rankings. The new model, which is nearly identical to what is used for the magazine’s procedures and conditions ratings, takes into account patient age, sex and Medicaid status as well as comorbid conditions.

Dive Insight:

Hospitals covet a good showing in the U.S. News rankings, which can drive positive publicity and investment.

Despite some controversy with HCAHPS surveys in the past, U.S. News got little pushback from hospitals on including its measures in the rankings methodology, Ben Harder, chief of health analysis for the magazine, told Healthcare Dive.

“Any time we do any statement or methodology change, there are going to be some misgivings about it, but I would say overall the industry has been supportive of that change,” he said.

U.S. News continues to tweak its methods to reflect “advances in the art and science of performance measures in healthcare” and shifts in the industry, Harder said.

“Healthcare delivery itself is changing rapidly and, in some ways, radically, so methodology changes we make are in some cases driven by those changes,” he said.

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The addition to the discharge at home factor is an example of those changes. The factor was added based on well-documented patient desires to recover at home whenever possible and avoid unnecessary time in a hospital.

The risk-adjustment changes come as CMS has tackled the issue in its own quality measures. Hospitals have been in a protracted tussle with the agency over its star rating system, arguing the methods failed to properly account for hospitals’ differing patient populations.

After delaying updates for more than a year, CMS released new star ratings in March, but did include a change that placed hospitals into peer groups in an attempt to avoid unfair comparisons. But the American Hospital Association and America’s Essential Hospitals said the tweaks weren’t enough to salvage the rankings.

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