The U.S. News & World Report Best Hospitals rankings are released each summer. Data from multiple sources dating back several years are used to calculate the results.
This year, 16 specialties were included in the rankings: Cancer; Cardiology & Heart Surgery; Diabetes & Endocrinology; Ear, Nose & Throat; Gastroenterology & GI Surgery; Geriatrics; Gynecology; Nephrology; Neurology & Neurosurgery; Orthopedics; Pulmonology & Lung Surgery; Urology; Ophthalmology; Psychiatry; Rehabilitation; and Rheumatology. Expert opinion is the sole basis for ranking these last four specialties.
In addition, U.S. News rates nine procedures and conditions annually. These include chronic obstructive pulmonary disease, congestive heart failure, coronary artery bypass grafting, abdominal aortic aneurysm, valve repair, colon cancer surgery, lung cancer surgery, total hip replacement and total knee replacement.
These specialty, condition and procedure ratings are combined to create an Honor Roll that recognizes the nation’s top 20 hospitals with the highest rankings across all areas.
This year, points were assigned to hospitals by their rank in each specialty, as well as by the number of “high performing” ratings for conditions and procedures. The points were summed across each of these areas, and the 20 hospitals with the most points were assigned to the Honor Roll. Hospitals were rank-ordered by the number of points, which determined the Honor Roll order.
U.S. News adjusts its methodology each year. This year, patient safety indicators were replaced by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a survey of patient experience. A second outcomes measure, discharge to home, was added, and changes were made to the mortality calculations.
To determine a hospital’s ranking, four main criteria are assessed: structure (30%), process (27.5%), outcomes (37.5%) and HCAHPS (5%) in 12 of the 16 ranked specialties.* Four of the 16 are based solely on expert opinion.
* In the Cardiology & Heart Surgery specialty, a fifth component — public transparency — is included and counts for 3% toward the specialty score. To offset this increase, the weight of the process component decreased to 24.5%.
Structure: 30% Structure refers to hospital resources directly related to patient care. Examples include the ratio of nurses to patients, patient volume, and key technologies or patient services offered.
Process: 27.5% Process refers to expert opinion of specialists, or reputation. In 2019, more than 100,000 specialists were asked for their opinion on which hospitals provide the best care for patients with the most challenging conditions or who require particularly difficult procedures. The survey was conducted online through Doximity.com and through a limited paper survey.
Outcomes: 37.5% Outcomes includes two metrics — survival score and discharge to home. Survival score looks at a specialty’s success in keeping patients alive 30 days after admission. Each specialty receives a score of 1 to 10, with 10 being the best. Discharge to home looks at the number of patients discharged home compared with the total number of patients discharged in a given specialty.
HCAHPS: 5% HCAHPS uses the summary star rating (linear mean score) of 10 publicly reported patient experience factors, including doctor communication, discharge information, care transition, cleanliness, quietness and willingness to recommend the hospital.