Why Hospital Rankings Are So Complicated

Tinker Ready, July 27, 2017

Ranking hospitals means constant tweaks and occasional errors in the effort to get it right. The effort is still a work in progress, but transparency and access to better data would help move things along.

A headline this month in The Boston Globe about a VA hospital in Manchester, NH couldn't have been any clearer: "At a Four-star Veteran's Hospital: Care Gets 'Worse and Worse.'"

It was remarkable, given the fact that late last year, the VA had "raised Manchester's quality rating from three stars to four, putting it in the top third of the entire VA system," according to the Globe.

Two days later, US News & World Report announced that it was delaying the official release of its annual hospital rankings after hospitals found errors during a preview of the data.

Related: Hospital Rankings Contradictory, Cryptic, Confusing

Measuring the quality of hospital care is an extremely complicated endeavor, both technically and politically. And the stakes are higher than ever for hospitals now that the Centers for Medicare & Medicaid Services has linked payment to quality.

Hospital ranking programs take that data to consumers, who are increasingly shopping around for health services. But when media reports challenge the analysis of the data, the question emerges: Are consumers losing confidence in hospital rankings?

Brian Kelly, the editor and chief content officer at US News, doesn't think so.

"Our audience has grown," he says. "We have 100,000 people a day coming to us to look at this information. And we feel very good about it. We think we are providing very comprehensive and very clear information for patients making decisions."

The discrepancy in this year's data emerged when hospitals reviewing their US News rankings prior to the public release pointed out "some things that looked out of whack," Kelly says.

His team went back, found a calculation error, fixed it, and rechecked all of the data. The publication date was moved from August 1 to August 8.

Tinker Ready

Tinker Ready is a contributing writer at HealthLeaders Media.

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