U.S. News & World Report on Tuesday released its 29th annual Best Hospitals rankings, with Mayo Clinic topping the publication's "Honor Roll" for the third year in a row.

For the 2018-2019 list, U.S. News evaluated over 4,500 hospitals and health care facilities across 16 specialties. In the latest list, 158 hospitals scored high enough to be included in the rankings. The publication also named 20 facilities to its "Honor Roll" for achieving strong performance in multiple specialties.

How hospitals were ranked

U.S. News ranked four of the 16 specialties—ophthalmology, psychiatry, rehabilitation, and rheumatology—by reputation, based on surveys of specialists. According to U.S. News, hospitals that ranked as "Best Hospitals" for these specialties received nominations from at least 5% of survey respondents within the last three years.

Cheat sheet: How US News calculates its 'Best Hospital' rankings

For the other 12 specialties, researchers determined rankings largely based on federal and industry data, although they also incorporated results from the reputational survey. The 12 data-driven specialties include:

• Cancer;
• Cardiology & heart surgery;
• Diabetes & endocrinology;
• Ear, nose & throat;
• Gastroenterology & GI survey;
• How to be data-driven
• Geriatrics;
• Gynecology;
• Nephrology;
• Neurology & neurosurgery;
• Orthopedics;
• Pulmonology; and
• Urology.

To qualify for this year's 12 data-driven lists, hospitals had to: be a teaching hospital; be affiliated with a medical school; have at least 200 beds; or have at least 100 beds and offer four or more types of medical technology considered by U.S. News to be key to high-quality care, such as PET/CT scanners. Out of the 4,656 hospitals and health care facilities in U.S. News' initial pool, 2,264 met at least one of those standards.

To achieve a ranking in a specific specialty, hospitals had to meet a volume/discharge requirement that varied by specialty or—if a hospital did not meet the volume/discharge requirement—hospitals had to have received nominations from at least 1% of the specialists responding to the reputational surveys in 2016, 2017, and 2018.

According to U.S. News, the 1,895 hospitals and health care facilities that met the requirements for at least one specialty were then scored based on four factors (with the exception of cardiology and heart surgery, which had a slightly different methodology):

• Outcomes, measured by risk-adjusted mortality (37.5%);
• Structure of hospital resources directly related to patient care (30%);
• Process of delivering patient care/expert opinion (27.5%); and
• Patient safety (5%).

Cardiology and heart surgery programs also were judged on a fifth factor: public transparency, for publicly reporting quality metrics through American College of Cardiology and the Society of Thoracic Surgeons websites. Public transparency was weighted at 3%, while process/expert opinion was weighted at 24.5%.

Honor roll

U.S. News recognized 20 facilities on an "Honor Roll." The facilities earned their spots on the list by demonstrating "exceptional treatment" in several areas. Honor roll awardees, ranked from one to 20, include:

One key to improving quality: Identifying clinical variation

1. Mayo Clinic (Rochester, Minnesota);

2. Cleveland Clinic (Cleveland);

3. Johns Hopkins Hospital (Baltimore);

4. Massachusetts General Hospital (Boston);

5. University of Michigan Hospitals-Michigan Medicine (Ann Arbor, Michigan);

6. UCSF Medical Center (San Francisco);

7. UCLA Medical Center (Los Angeles);

8. Cedars-Sinai Medical Center (Los Angeles);

9. Stanford Health Care-Stanford Hospital (Stanford, California);

10. New York-Presbyterian Hospital (New York);

11. Barnes-Jewish Hospital (St. Louis);

11. Mayo Clinic Phoenix (Phoenix);

13. Northwestern Memorial Hospital (Chicago);

14. Hospitals of the University of Pennsylvania-Penn Presbyterian (Philadelphia);

15. NYU Langone Hospitals (New York);

15. UPMC Presbyterian Shadyside (Pittsburgh);

17. Vanderbilt University Medical Center (Nashville, Tennessee);

18. Mount Sinai Hospital (New York);

19. Duke University Hospital (Durham, North Carolina); and

20. Brigham and Women's Hospital (Boston).

Reaction

John Noseworthy, president and CEO of Mayo Clinic, said the Clinic is "humbled and honored to be recognized by U.S. News & World Report." He added, "This ranking recognizes Mayo Clinic as a destination medical center for patients with complex and serious illnesses, our staff's total commitment to patient care, and the extraordinary depth and breadth of our medical practice" (U.S. News release, 8/14; U.S. News Honor Roll, 8/14; U.S. News methodology, accessed 8/14; Mayo Clinic release, 8/14; Pointer, WTOP, 8/14).

Get the cheat sheets: How hospital quality ratings programs work

Download our one page sheets for summaries on the methodology and metric categories used in five hospital quality rating programs:

• US News and World Report Best Hospital Rankings
• US News and World Report Best Children's Hospital Rankings
• CMS Star Ratings
• Leapfrog Group Hospital Safety Grade
• Healthgrades Patient Safety Ratings and Excellence Awards
• Watson Health 100 Top Hospitals

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