Do Healthcare Rankings Help or Hinder Consumer Choice?

There are two rankings that can define a hospital communicator’s entire year: U.S. News & World Report’s “Best Hospitals” and Modern Healthcare’s “Top 100 Most Influential” list of leaders. This is probably most relatable to leaders at major academic medical centers and large health systems, but if that’s you, you get it. 

To those outside of the industry, the influence of communications on these healthcare rankings may be lost on them.  They may not understand the role of reputation in rankings – and everything that goes into building, growing, and perhaps most importantly, protecting it. All impacted by how your organization shows up internally and externally, with rankings often criticized for how heavily subjective measures factor into the methodology.

This year, U.S. News acknowledged some of this criticism by shifting to more objective measures. Historically, expert opinion has been weighted as about a quarter of an organization’s score – which includes physicians who nominate up to five hospitals in their specific field that they consider best for patients with serious or difficult conditions. This year, that dropped to between 12% and 15%, depending on the specialty.

Instead, the methodology focused more on measures such as federal outcomes data and structural indicators of quality, such as availability of key patient services, which account for 45% and 35% of the rankings data, respectively.

But is this good enough? Some continue to say no. U.S. News has been considering incorporating health equity measures to account for diverse care settings where care is delivered but has not yet done so. This decision has led Penn Medicine to shift its focus away from participation in U.S. News rankings and they aren’t alone. 

Healthcare rankings have even attracted the attention of officials such as San Francisco Attorney David Chiu, who is questioning methodology and looking into who really benefits from what is a big business for organizations like U.S. News. Once attaining recognition, hospitals must pay upwards of $40,000 to use the U.S. News “Best Hospitals” badge.

We can all agree that consumers need access to information like healthcare rankings to make informed choices, but what we still can’t agree upon is what type of information they need to make those decisions. Is it better to have something – even if it is flawed? Or is it more dangerous to have subjective information that can cloud patient decision-making?

The research shows that consumers are increasingly using online tools to help inform decision-making, but we have a long way to go and much of it relies on educating consumers about how to make comparisons, including pricing. That’s where rankings add value by piecing together elements to help consumers make an educated decision.

Think about Yelp! and Amazon – how do you research a restaurant or a potential purchase?  Quality is subjective when you evaluate those rankings, as well, but it’s a starting point for continued conversations and research.

As hospital communicators, can we continue to participate in healthcare rankings programs and should we put marketing dollars behind them? Yes, and not because it’s the best option, but rather because it’s the best option that we have right now.  Let’s use them as a jumping off point to talk about quality and to help people make more educated decisions (always with healthcare literacy at the forefront). 

Not everyone needs to go to one of the top hospitals in the country for every procedure, because after all, most healthcare is (and should be!) delivered locally. Let’s shift the conversation to more educated decision- making that can be applied at every level.  Where can you go to get information and how should you evaluate it?

As the old saying goes, we don’t have to throw the baby out with the bath water. U.S. News is clearly listening to some of the criticism it has received – and vocal opponents are helping to evolve the current system. With a 30-plus year history of ranking hospitals (and a lot of hospital marketing dollars put behind promoting rankings), U.S. News has established some awareness among consumers to help them evaluate their healthcare options.

Let’s build upon what’s working and fix what’s not by building new tools that reflect the change we want to see. Imagine what might happen if hospitals applied their marketing dollars to establishing awareness of a new tool that we all agreed upon?

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