A question healthcare executives have been whispering is now being said aloud.
Several factors are giving the question a far louder microphone. In Florida, there is ongoing litigation between The Leapfrog Group, which grades hospitals twice a year on safety measures, and a five-hospital system based in Palm Beach. In July 2025, CMS dropped four quality measures and altered four others. The Joint Commission, which does not rank hospitals but accredits them, halved its accreditation standards from 1,551 to 774.
The question at the heart of it all: Are hospital rankings improving care, or mainly pushing organizations to chase publicly visible grades at the expense of the work that helps patients most?
Few leaders argue against transparency. The worry is whether the growing pile of scorecards reshapes how systems spend finite time and money. And the pressure runs two ways. Even as CMS and The Joint Commission trim measures, health systems are building more internal dashboards to judge them by the same measures the rankings do.
The pushback isn’t confined to Leapfrog. A few years ago, Bethlehem, Pa.-based St. Luke’s University Health Network and Philadelphia-based Penn Medicine’s University of Pennsylvania Health System both stopped submitting data to U.S. News & World Report‘s Best Hospitals rankings. The publication has repeatedly revised its methodology in response to criticism.
“Hospitals sometimes chased rankings by devoting time and money to improve performance measures that mattered only because they were part of the U.S. News methodology,” Penn Medicine CEO Kevin Mahoney told Becker’s in 2023.
The strain shows where dollars are finite. In a recent Vizient roundtable of quality executives summarized by consulting firm Kaufman Hall, leaders described weighing publicly reported scores against quieter safety work. One recounted an internal debate over whether to buy safe patient handling equipment to prevent pressure injuries or to fund initiatives tied to reported metrics and financial return.
The cost is concrete. One health system reported spending more than 380 hours on ranking submissions for seven hospitals. Another put nearly $1 million into hand hygiene-monitoring technology, largely to support reporting — all on top of existing obligations to CMS, accreditors and state agencies.
“Do you want to spend your money on filling out a survey, or do you want to spend your money on actually improving processes at the patient level?” one executive asked during the roundtable, according to Kaufman Hall.
The fight turned public in Florida. In March, a federal judge sided with five hospitals in Tenet Healthcare’s Palm Beach Health Network, ordering Leapfrog to strip their “D” and “F” grades. Leapfrog is appealing.
Some leaders are quietly rewriting how they use rankings at all. At West Boca Medical Center in Boca Raton, Fla., part of Tenet, the focus has moved from the grade to the measures beneath it.
“The focus should be on the metrics themselves and not necessarily the survey or the ranking or the organization that is applying that,” CEO Jerad Hanlon told Becker’s. “Our goal is to focus on things like our central line-acquired infections, our pressure ulcers and the things that truly impact patient safety and care.”
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