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

What resulted is drastically different rankings than other systems. For example, Rochester, Minn.-based center Mayo Clinic won the No. 1 spot on U.S. News’ rankings[4] last year for the fourth year in a row, but Mayo​’s highest rated facility, in Albert Lea, was ranked 81 in Lown’s list.

Lown said the differences were because many hospitals rely on a business model that relies on attracting wealthier patients from outside their immediate community, while doubling down on patient satisfaction by offering high-class amenities, like private rooms, and lucrative specialized procedures.

“There are some very fine hospitals that feel forced to focus on profitable elective procedures to stay in business,” Lown Institute President Vikas Saini said in a statement on the index.

This can lead to business decisions that make them look good on outcomes like mortality, but at the expense of equity. The data show that gaps between a hospital’s clinical results and its performance in the community are sometimes very wide, which can contribute to disparities in care and put certain communities at risk,” Saini said.

The top-performing hospitals in the rankings are various sizes, but all are nonprofits located in urban areas. Larger, teaching hospitals, which the ranking found generally provide better care for common conditions and have lower rates of patient mortality, are overrepresented in the top 100.

However, many small rural facilities and safety net hospitals outrank other big name hospitals by doing slightly better on inclusivity, Lown said.

The top 10 hospitals in the Index are: 

  1. JPS Health Network, in Fort Worth, Texas
  2. Marshall Medical Center, in Placerville, California
  3. UPMC McKeesport, in McKeesport, Pennsylvania
  4. Seton Northwest Hospital, in Austin, Texas
  5. Mercy Health-West Hospital, in Cincinnati
  6. Wellstar Douglas Hospital, in Douglasville, Georgia
  7. Providence Portland Medical Center, in Portland, Oregon
  8. Health Alliance-Clinton Hospital, in Leominster, Massaschusetts
  9. Memorial Hermann Texas Medical Center, in Houston
  10. Parkland Health and Hospital System, in Dallas

UPMC McKeesport is managed by Pittsburgh-based system UPMC, which operates 40 hospitals in the region; Seton Northwest is owned by Catholic system Ascension, one of the largest hospital operators in the country with 150 hospitals across 20 states; Mercy Health-West is owned by 50-hospital operator Bon Secours Mercy Health and Providence Portland is owned by 51-hospital Catholic nonprofit Providence.

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