U.S. News & World Report is making various methodology changes that will be reflected in this year’s edition of its “Best Hospitals Procedures and Conditions” ratings when they are published July 29.
The changes will be used to determine ratings of 22 benchmark surgical procedures and medical conditions.
U.S. News said it expects the changes “to improve the ratings’ utility to patients and families — and better align the methodology with hospitals’ internal quality improvement initiatives.” The media company incorporated feedback from physicians, nurses and hospital leaders when developing the changes, according to a post on “Second Opinion,” a U.S. News blog of editors and invited contributors.
Below is a summary of the major updates to the rating metrics:
1. A weight-based approach will replace the previous use of confirmatory factor analysis to calculate composite scores.
2. U.S. News will weigh outcomes more heavily. A hospital’s performance on a suite of risk-adjusted outcomes will determine up to 75% of its composite score in each procedure and condition.
3. New metrics will gauge prevention of outpatient procedural complications in the both knee and hip replacement ratings this year. They are rates of survival, discharging patients to home and giving patients time at home.
4. Two new cohorts, arrhythmia and pacemaker, will be added to the existing procedures and conditions ratings, for a new total of 22 ratings.
5. Hospitals will be evaluated this year on their risk-adjusted survival rates for patients insured through Medicare Advantage, alongside traditional Medicare beneficiaries.
6. Nursing care, previously folded into the nurse staffing metric, will be assessed in greater detail by considering not only nurse staffing levels (relative to patient days), but also by including patient-reported nurse communication scores from theHospital Consumer Assessment of Healthcare Providers and Systems survey.
7. To help ensure greater consistency, both from year to year and from cohort to cohort, the media company will designate up to 30% of hospitals evaluated — up to a maximum of about 500 — as “high performing” in each procedure or condition.
8. For 11 of 15 data-driven adult specialties, U.S. News will lower the weight of nurse staffing measurements and reduce the cap from approximately 3.0 to 2.4.
More information about the changes is available here.
