Criticism spreads to US News' hospital rankings

U.S. News & World Report has been receiving backlash for its medical school rankings since the beginning of the year. Now, that discontent is spreading to its popular best hospitals rankings. 

On May 24, the CEO and chief quality officer of St. Luke's University Health Network in Bethlehem, Pa., announced they would no longer submit data to the publication, which requests information from children's hospitals and hospitals offering maternity care to compile its rankings. The executives alleged the rankings run on "misguided methodology" in a letter to Ben Harder, U.S. News' managing editor and chief of health analysis. 

The health system's letter criticized the publication for incorporating "expert opinion" scores from physicians into its methodology; it alleged that using subjective criteria is akin to a popularity contest and that the rankings are primarily used to generate marketing revenue. 

On June 20, the rankings were questioned on the opposite coastline. David Chiu, San Francisco's city attorney, sent a letter to U.S. News asking for evidence to substantiate its claims that the hospital rankings are "authoritative," based on "world-class data and technology," and help patients and families "find the best healthcare," "make data-informed decisions," and "find sources of skilled inpatient care." 

Mr. Chiu's letter says the publication appears to violate Federal Trade Commission regulations by not disclosing payments it receives from the hospitals it ranks, including fees to license Best Hospitals badges, subscriptions to Hospital Data Insights, and payments for advertisements on the website and in the Best Hospitals Guidebook.

Less than a week after Mr. Chiu's letter, Philadelphia-based Penn Medicine's University of Pennsylvania Health System became the second health system to withdraw from the rankings.  Kevin Mahoney, the health system's CEO, spoke against the rankings in a June 26 news release. 

"The U.S. News and World Report 'Best Hospitals' methodology changes regularly, making it difficult to meaningfully draw conclusions about hospital quality over time, let alone the enormous amount of care provided outside the hospital," said Patrick Brennan, MD, Penn Medicine's chief medical officer. "More importantly, these measures do not help us deliver better care for our patients, and they incentivize health systems to expend resources both to compete for placement in the rankings and promote their position on the list." 

The health system will no longer submit data to U.S. News or the American Hospital Association's Annual Survey, which the publication uses for rankings. It plans to create its own dashboard to share such data. 

U.S. News Executive Chair and CEO Eric Gertler disagrees with the recent characterizations of the hospital rankings, he said in a prepared statement shared with Becker's. He holds that the rankings provide an "important journalistic and public service" to those seeking medical care, although they should only be one factor in that decision-making process. 

"Our healthcare journalists and data analysts who develop the rankings take their responsibility to produce quality journalism very seriously, which has earned the trust of consumers for more than 30 years," Mr. Gertler said. "Our expert journalistic teams painstakingly evolve the methodology each year to reflect changes in how healthcare gets delivered and in response to input from clinicians, hospital leaders and other healthcare stakeholders. This year's rankings, for example, will be the first to incorporate measures of patient outcomes following outpatient surgeries, reflecting the growing role of outpatient care."

"Families facing a serious or complex medical problem deserve to have a place that helps them determine which hospital is the best suited for their individual needs," Mr. Gertler continued. "Consumers rely on information from trusted, independent sources like U.S. News, and we remain committed to serving them by evaluating and comparing all eligible hospitals on their quality of care."

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