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The Big Story: Hospital Rankings Shift Emphasis to Objective Data Away from Expert Opinion

“This shift reflects our ongoing effort to use more objective data in our hospital ranking methodologies.”

What it Means for You – 4-minute read

By David Jarrard

Everybody loves a good list.

Whether it’s gold medals, pop music or revenue numbers, everyone wants to see who’s among the top 100, or top 10 or number one. And, better yet, to be among them.

Our industry is awash in rankings because health systems are led by people (at least today, until the chatbot revolution is complete).

Rankings can be a valuable shorthand for a swath of audiences important to you.

Any decent list that serves as an objective endorsement of success is assuring to lay audiences, who don’t have the expertise or time to assess deeper healthcare data, and as bragging rights for audiences in the know.

So, when a popular top chart maker changes in its ranking methodology, our industry rightly pays attention.

U.S. News’ latest formula adjustment reduces the weight of a hospital’s reputation – basically, the opinion of physicians – from 25-30 percent to 12-15 percent for most specialties. This, at a time when some medical schools and law schools are abandoning participation in their respective lists all together, claiming the ranking algorithms can’t fully capture the unique value of their offerings.

Which begs the question: Who are these rankings for, anyway, and how much investment of your time and energy do they warrant?

Our take? A list that fairly compares competitors, used wisely, can be a helpful communication tool to certain audiences. But lists can only go so far in giving people a true picture of the value or experience they’ll receive. Focusing too much on your position can become an expensive distraction to your true work.

So now, of course, we offer you a list.

10. Prestige is a valuable coin to carry for physicians, nurses and – if applicable – alumni. Who wouldn’t want to work at an organization that’s up the list? It’s important to have a well-regarded institution on your resume. And potential donors want to know their money is going to a top spot. In this moment of talent wars, workforce shortages and financial shortfalls, ranking can be an important selling tool.

9. Patients care about care. Readmission rates and outcome data are the technical criteria used for these rankings and matter deeply. And research shows that hospital reputation is a key metric for patients in choosing a provider. Still, the personal and local touch matters. Our team’s experience with focus groups and surveys indicates that rankings have little to no bearing on where people choose to receive care. Consumers are concerned about the organization’s reputation at a local level, a recommendation from a local physician or the cost of care, to say nothing of the experience they – or friends and family – have when they come in for a visit. Plus, with social media and online search, they’re doing their own research to choose a provider that fits them well.

8. Medical schools out, hospitals in? Academic medical centers that appear on U.S. News’ hospital list – but whose affiliated medical schools have opted out of the rankings – may have a unique challenge during this time. “Dropping out” may not be an option since hospital rankings are built from publicly available data. Marcomm teams will need to develop clear message explaining to alumni, employees, physicians and recruits the apparent discrepancy of their institution appearing on one list but not the other.

7. Don’t expect too much to change. US News’ re-weighting is notable but not earth-shattering. It’s happened before, and this latest adjustment likely won’t lead to an entirely new list that sinks your organization to the bottom quartile overnight, or vice versa.

Side eye: However, reducing the value of reputation and the subjective opinion of physicians strikes us as further commentary on the erosion of public trust for all “experts.”

6. Don’t “Well, actually…” the rankings. Every ranking system is flawed. But individually and collectively, they’re directionally helpful and tell a story. Trying to elevate your brand by pointing to the flaws is a poor investment. Focus on the reasons behind the ranking – to give stakeholders a general idea of where institutions sit among their peers in providing care – and discuss what your organization is doing that no ranking (especially a flawed one) will capture.

5. Take the broad view of quality. Remember, technical criteria are only part of the equation. The perception of quality goes much further than the measured “outcome” or the HCAHPS-approved steps taken along a care path. For most patients, the “quality of care” experience begins well before and extends well after they are in your hospital bed.

4. Spend where it matters. The US News adjustment is a good reminder that your place at the table is to speak for patients and potential patients, then to help the leadership team accomplish its goals with those customers in mind. With the reduced emphasis on reputational score, be sure to also include resources put towards strategic marketing and patient acquisition work that connects with people in thoughtful, personalized ways – emphasizing other things that matter to them as they seek care.

3. Everybody is on a list. Every health system appears on somebody’s top 100 list. Some are questionable, pay-to-play rankings, some are valuable peer-to-peer yardsticks.

Yet if everybody is special, nobody is. Rankings have become table stakes instead of unique elevations of outstanding performance.

The result? The practical value of rankings is hard to suss out. If reputation matters to patients, who’s measure of reputation is the gold standard? Participating may be a got-to-have for a host of internal and external political reasons, but a great placement on a good list is no longer enough to get your communications ball over the goal line, if it ever was. (Note: That’s the last time a football metaphor will be used. Until the fall.)

2. Stick to the knitting. Our Chartis colleague Floyd Pitts recently wrote an article about medical schools opting out of U.S. News rankings. In it, he said, “More importantly, health systems should not get too lost in the rankings metrics. Providing highly reliable care that is top quality and safe will help organizations improve rankings and deliver the best care to their patient populations.”

Don’t make rankings the headline but a supporting message, if relevant. Rather than framing the question as, “How do we improve our rankings?” try, “How do we improve patient care and patient experience?” and “How do we tell the story of that experience?” Focus on getting those things right and the reputation and quality will follow.

You know all of this, of course. But, sometimes, boards and leadership teams and high performers of all stripes can lose this perspective when the competitive juices get flowing.

You may find your most important work around any ranking is to bring the context back to your mission.

1. Rule of 10. By law, all lists must be a multiple of 5. So, we’re in compliance.

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