Hospital rankings and ratings remain a visible part of healthcare, but some CEOs say their focus is less on the grade itself and more on whether the underlying measures can guide operations, quality improvement, patient experience or financial stability.
Becker’s spoke with Jerad Hanlon, CEO of West Boca Medical Center in Boca Raton, Fla., part of Dallas-based Tenet Healthcare, and Scott Rathgaber, MD, CEO of Emplify Health — the organization formed by the merger of La Crosse, Wis.-based Gundersen Health System and Green Bay, Wis.-based Bellin Health — about how their organizations think about ratings and rankings in 2026.
The discussion comes as hospitals continue to evaluate ratings methodologies following recent legal disputes involving The Leapfrog Group’s hospital safety grades. In March, a federal judge in Florida sided with five hospitals operated by Dallas-based Tenet Healthcare’s Palm Beach Health Network, which argued Leapfrog unfairly penalized hospitals that did not participate in its voluntary survey process. Leapfrog has said it plans to appeal the ruling. In its spring 2026 safety grades, the organization did not grade roughly 450 hospitals that did not participate in surveys.
How leaders use ratings operationally
Both leaders said rankings and ratings are most useful when they point to specific areas for improvement rather than serving only as external validation.
Dr. Rathgaber said Emplify starts with organizational priorities around workforce engagement, patient experience, quality and safety, population health, affordability and financial stability, then looks for metrics that can help measure progress.
“We start with those and then ask what metrics or measures out there can help guide us to improve,” he said.
Mr. Hanlon described a similar approach, saying ratings and measures can help identify where teams should focus next.
“Obviously, we want to keep patient care at the forefront, but how we deliver that patient care is going to change,” he said. “If you measure what you treasure, and we develop an action plan, identify a problem or an area that we need to improve, implement a root-cause analysis and implement a plan to fix that, and we fix and hardwire that process, it’s not that we’re going to stop keeping tabs on it. But we divert to the next task at hand.”
At West Boca Medical Center, patient satisfaction is one current area of focus.
“We score very well on our quality measures for our CMS star rating,” Mr. Hanlon said. “Where we struggle right now is patient satisfaction.”
He pointed to HCAHPS — the Hospital Consumer Assessment of Healthcare Providers and Systems survey used by CMS to measure patients’ perspectives on hospital care — as a standardized benchmark across markets.
“With HCAHPS being consistent across the nation, you’re getting an apples-to-apples comparison,” Mr. Hanlon said. “So we’ve got to raise our level of patient satisfaction to meet that national standard.”
Balancing ratings with strategy
For Dr. Rathgaber, the value of a rating or benchmark depends partly on whether the organization understands the methodology and can use the information to improve.
“The reason why is because we know most of the methodology, so we know how to get better,” he said. “They give us insight rather than just a grade.”
For example, bond ratings help guide targets around days’ cash on hand and cash-to-debt ratios. The system is less focused on moving from an A-plus to a double-A minus. Rather, it monitors ratings as a sign of stability amid an increasingly volatile industry.
“Stability is important, especially in our current industry,” Dr. Rathgaber said. “We don’t want to be whiplashed up and down. Bond ratings should be stable. Quality should always be continuously improving, and hospital performance should continue to improve too.”
Both CEOs said health systems also have to weigh the operational value of ratings programs against the administrative resources required to participate.
“There is some administrative effort that goes into filing, paying attention and making sure we talk to these organizations,” Dr. Rathgaber said. “But we think it’s an investment, and there’s a return on that investment because the return is improving our quality or making sure we’re financially stable and have good access to capital.”
Mr. Hanlon said hospitals regularly evaluate whether ratings programs are focused on measures that directly support patient safety and care.
“We get approached by a lot of different organizations, and what we have to evaluate is how this is truly going to impact and advance the quality of care that we’re providing to our patients,” he said.
For West Boca, that means focusing less on the ranking entity itself and more on the underlying measures.
“The focus should be on the metrics themselves and not necessarily the survey or the ranking or the organization that is applying that,” Mr. Hanlon said. “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 that we’re providing in our hospitals.”
Reputation, patients and consumer strategy
Rankings and awards may have reputational value, but Dr. Rathgaber said Emplify does not view them as a primary patient acquisition strategy.
“I actually pulled some of my executive leaders aside before I talked to you and asked whether I was off base here,” he said. “I asked whether patients pick us because we have [certain achievements], and we really don’t think they do. Our marketing department doesn’t think it’s that big a deal.”
He said patients and employers often assume hospitals are delivering high-quality care, which places responsibility on organizations to meet that expectation regardless of external recognition.
“I think patients just assume our quality is great,” Dr. Rathgaber said. “I tell our folks we have a sacred duty to our patients, communities and employers to be good at that because they already assume we are.”
Rather than relying on awards, he said Emplify focuses more on differentiating through experience.
“We drive differentiation through experience — white-glove care, empathy and those sorts of things,” Dr. Rathgaber said. “We can put up a billboard saying we won a patient experience award, but if you walk in our door and we treat you poorly, you’re not going to believe that. We have to win people over one encounter at a time rather than rest on the laurels of somebody giving us a trophy.”
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