FEATURE
Features
The
Rank
Tank
Are public health-
care ratings an
indicator of quality
or of popularity?
E
ach summer, U.S. News & World
Report releases its list of the best
hospitals in the nation, but this
year, centers eagerly awaiting the
results had to wait a little longer: The
publisher postponed the public release of
its annual hospital rankings by one week
after discovering errors in the data used to
compile the report. 1
The errors were attributed to a new
methodology used in the 2017-2018
rankings that were intended to “allow [the
publisher] to better assess hospital care,”
according to correspondence between U.S.
News & World Report and participating
hospitals. The changes “are complex to
implement, and we discovered errors late
ASHClinicalNews.org
in the process,” the publisher explained.
“We are confident that once correctly
implemented, these changes will benefit
our shared goal of providing patients with
better information about their health care.”
The rankings were eventually released
August 8, 2017, with few surprises about
which hospitals landed a top-10 spot, but
this year’s blunder raised questions about
the validity and value of such ranking
systems. 2
For instance, how much credence do
patients and health-care professionals give
to these rankings? Do they offer realistic
evaluations of a health-care facility’s level
of care, or are they simply a marketing
tool? How are they developed? And,
finally, what should physicians and other
health-care professionals do with this
information – embrace it or ignore it?
ASH Clinical News sought a clearer
picture of how public ranking systems can
advance – and impede – the common goal
of better medical care.
Rankings Roundup
The health-care rankings field is crowded
with both consumer and federal agen-
cies offering recommendations. The U.S.
News & World Report rankings are argu-
ably the most established, but consum-
ers can also consult rankings from The
Leapfrog Group, Healthgrades, Consumer
Reports, and even Yelp.
The Centers for Medicare and Med-
icaid Services’ (CMS’) Hospital Compare
website ranks more than 4,000 Medicare-
certified and Veterans Affairs hospitals
from one to five stars to help users decide
where to access health care – and to
encourage hospitals to improve the quality
of the care they provide. 3
CMS’ Consumer Assessment of Health-
care Providers and Systems (CAHPS) survey
uses standardized measurements of patients’
perspectives on hospital care “to allow objec-
tive and meaningful comparisons between
hospitals on domains that are important to
consumers.” 4 These items complement the
data hospitals already collect to “support
improvements in quality-related activities.”
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