New hospital rankings show ‘elite’ facilities struggle with health equity, inclusivity

Dive Brief:

  • A new ranking[1] of U.S. hospitals found many renowned institutions with good clinical outcomes struggle to address health inequities in their communities.
  • The Lown Institute, a Massachusetts-based think tank, compared 3,300 U.S. hospitals on 42 performance indicators under three categories: care value, care quality and “civic leadership,” or a commitment to equity and inclusion measured by pay equity, community benefit and inclusivity.
  • It found an inverse relationship between inclusivity and patient outcomes that could be due to differences in resources or patient mix, with Lown researchers noting smaller, lesser-known hospitals are more inclusive than their well-known, well-funded peers in many cities. Though “elite” hospitals did well on some measures, few appeared near the top of the list.

Dive Insight:

Hospitals compete fiercely to end up in the top slots of a number of lists from government agencies like CMS and private groups like U.S. News & World Report, Healthgrades and Leapfrog. 

A report last year[2] in the the New England Journal of Medicine found many rating systems misclassify hospital performance, which can mislead consumers. Yet in the opaque U.S. healthcare system, hospitals tout the rankings — which can produce drastically different results — as evidence of their superior medical abilities, nudging consumers to one site or another.

While most ranking methodologies only include metrics for patient outcomes and satisfaction, the new ranking from Lown factors in hospital’s community health investments, pay equity and inclusivity, though outcomes are still most heavily weighted. The think tank pulled data from a slew of sources, including CMS, the American Hospital Association and publicly available records from the IRS, SEC and Bureau of Labor Statistics.

The rankings are the first to take into account how well hospitals serve minority and low-income communities, according to Lown, partially by measuring the degree[3] to which its patient demographics match those found in its community.

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