U.S. News & World Report on Tuesday released its 30th annual Best Hospitals rankings, with Mayo Clinic topping the publication's "Honor Roll" for the fourth year in a row.

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

For the 2019-2020 list, U.S. News drew from the 4,653 hospitals and health care facilities in the American Hospital Association's Annual Survey of Hospitals.

U.S. News evaluated facilities across 16 specialties. In the latest list, 165 hospitals ranked in at least one specialty.

The publication also named 20 facilities to its "Honor Roll" for achieving strong performance in multiple specialties.

How hospitals were ranked

To qualify to be ranked as one of the top specialty hospitals, hospitals must meet one of the following criteria:

• 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.

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

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

• Cancer;
• Cardiology & heart surgery;
• Diabetes & endocrinology;
• Ear, nose, & throat;
• Geriatrics;
• Gastroenterology & GI Surgery;
• Gynecology;
• Nephrology;
• Neurology & neurosurgery;
• Orthopedics;
• Pulmonology & lung surgery; and
• Urology.

To achieve a rating 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 over the past three years.

According to U.S. News, 1,870 hospitals were eligible to be considered for a rating among the 12 data-driven specialties. Eligible facilities 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 experience (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%.

This year, U.S. News added the patient experience metric, based on HCAHPS patient satisfaction surveys, as well as a new outcome metric that examines how often patients go directly home rather than to a nursing home or institutional care setting.

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:

1. Mayo Clinic (Rochester, Minnesota);

2. Massachusetts General Hospital (Boston);

3. Johns Hopkins Hospital (Baltimore);

4. Cleveland Clinic (Cleveland);

5. New York Presbyterian Hospital-Columbia and Cornell (New York);

6. UCLA Medical Center (Los Angeles);

7. UCSF Medical Center (San Francisco);

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

9. NYU Langone Hospitals (New York);

10. Northwestern Memorial Hospital (Chicago);

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

12. Stanford Health Care-Stanford Hospital (Palo Alto, California);

13. Brigham and Women's Hospital (Boston);

14. Mount Sinai Hospital (New York);

15. UPMC Presbyterian Shadyside (Pittsburgh);

16. Keck Hospital of USC (Los Angeles);

17. University of Wisconsin Hospitals (Madison, Wisconsin);

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

18. Mayo Clinic-Phoenix (Phoenix);

20. Houston Methodist Hospital (Houston); and

20. Yale New Haven Hospital (New Haven, Connecticut).

All 20 are Advisory Board members.

 (U.S. News release, 7/30; U.S. News Honor Roll, 7/30; U.S. News methodology, 7/30).