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Another hospital tops U.S. News rankings—again. But does it matter?

July 15, 2014

    Dan Diamond, Managing Editor

    Another year, another edition of the U.S. News "Best Hospital" rankings.

    And once again—a new organization named #1.

    It's the third straight year that there's been a shift at the top of the rankings. And that's a bit unusual, because the best of all the U.S. News "Best Hospitals" had been somewhat of a formality for decades: Johns Hopkins led the rankings every year from 1991 to 2012.

    But Mass General ascended to the top spot in the rankings two years ago, before Hopkins reclaimed the lead position in 2013. This year, it's Mayo Clinic's turn at #1.

    See: U.S. News names its 2014 'Best Hospitals' list

    After decades of stability—at least in the rankings—are things changing that quickly in health care? Or is U.S. News just changing how it evaluates organizations? 

    I asked their rankings team.

    "We did make some methodology refinements [this year], as we do every year," editor Ben Harder told me. And an important change in 2014 "was our decision to add more patient safety metrics to our model," specifically data that tracked in-hospital post-operative hip fractures and in-hospital pressure ulcers. 

    Altogether, U.S. News ended up doubling the total weight they assigned to each hospital's patient safety score—and the gap between Hopkins and Mayo's relative safety scores ended up explaining this year's shift, Harder added.

    Hospitals are still grappling with a broad question about rankings, of course: How much do they actually matter to patients and providers? (Advisory Board research suggests that the buzz around rankings outweighs their impact.)

    So how important is the churn at the top of the list, really? It's obviously relevant to hospitals that are jockeying for the #1 spot—"What a disaster!" Harvard health policy professor Ashish Jha joked to the Baltimore Sun, discussing Hopkins' drop this year to #3but there's limited evidence that top organizations see much ROI from a subtle gain or slide in where they end up.

    As Jha put it to the Sun, "the bottom line is that Hopkins remains one of the very best hospitals in the world." 

    "I am unaware of anything meaningful that has changed."

    From the Daily Briefing

    See more on this year's "Best Hospitals" list, as well as a Q&A with an Advisory Board expert on how to think about hospital ratings.

    Looking at the U.S. News methodology and the "Honor Roll" hospitals

    Do hospital rankings actually matter? Expert weighs in

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