Revisiting US News & World Report’s Hospital Rankings—Moving Beyond Mortality to Metrics that Improve Care

Excerpt

In the current era of healthcare reform, with greater attention to the quality of care delivered, having valid metrics to guide patient decision-making remains critically important. US News & World Report’s (USNWR) ranking of hospitals (and specialties) is influential and oft cited in grading the care that hospitals deliver.^{1, 2} USNWR intends the rankings to be used by patients, and ranked hospitals cite USNWR ratings in most (61%) of their direct-to-patient advertising.³ In addition, one survey of hospital leaders indicated that the vast majority (87%) felt that USNWR rankings were accurate and utilized them for advertising hospital quality.⁴ The USNWR rankings have not been without criticism though, namely, their historical reliance on reputation versus objective metrics.^{2, 5} In response, USNWR has shifted to weigh seemingly objective metrics more heavily, focusing particularly on mortality, which can be quantifiably measured using Centers for Medicare & Medicaid Services (CMS)-based data. To its credit, USNWR acknowledges the limitations of these “imperfect” measures, and its methodology in not just reputation, but also in quality assessment, highlighting potential inaccuracies due to claims data and unadjusted confounding.⁶ In this viewpoint, we advocate for the use of metrics beyond mortality to better reflect patients’ experiences with receiving hospital care, as they can help promote patient-centered care. …