Doximity is the exclusive provider of the U.S. News Best Hospitals and Best Children’s Hospitals expert opinion physician survey, which contributes to the rankings that help families find the best care for adults and children when they need it most. As U.S. News survey season approaches, it kicks off a flurry of questions about methodology, strategy, and best practices. Your Doximity client success team is always available for questions regarding your individual U.S. News strategy. Generally, for hospitals and health systems interested in increasing their brand awareness among physicians, we recommend getting in front of physicians all year long. This comprehensive strategy ensures that your brand is well-known and top-of-mind among your brand allies.
As for methodology, U.S. News’ blog, Second Opinion, is the best place to get the most up-to-date information regarding the Best Hospitals survey. Below is a repost from the Second Opinion blog from June 29, 2022 detailing the changes to the methodology for 2022-2023.
What’s New in This Year’s Best Hospitals Methodology
Coming: New cancer ratings, a new patient-centered outcome measure and more health equity measures
By Ben Harder
Best Hospitals Methodology Changes
When published on July 26, the 2022-2023 Best Hospitals rankings and ratings will reflect several methodology improvements. Yet even as the methodology evolves each year, the mission remains the same: to provide data-driven decision support to patients and their families so they, with their doctors, can make informed choices about where to seek care for specific hospital services.
What follows is a high-level summary of certain key changes; hospital staff who are registered users of the Best Hospitals Dashboard will be able to access a detailed methodology report, along with a preview of their hospital’s rankings and ratings, beginning July 7. To log in or sign up, visit https://hospitaldashboard.usnews.com.
Methodology changes implemented in this year’s edition of Best Hospitals will include:
COVID-19’s impact on care delivery.
Outcome and volume measures this year included data from the first year of the COVID-19 pandemic. To adjust for the pandemic's varied impact on different hospitals, cases were excluded from outcome measures if they occurred during March 2020, if they involved a diagnosis of COVID-19 or if they occurred during a month in which the share of the hospital’s inpatients who had COVID-19 exceeded either 15% or the national average among Medicare beneficiaries for that time period, whichever was lower. In calculating volume measures, U.S. News re-used a hospital’s volume from the prior reporting period (for example, 2017-2019) in any specialty or cohort in which that volume was more favorable to the hospital than its volume for the current reporting period (for example, 2018-2020).
Three new ratings.
This year, for the first time, eligible hospitals will receive ratings in Ovarian Cancer Surgery, Prostate Cancer Surgery, and Uterine Cancer Surgery. The methodology behind each of these new ratings is broadly similar to the methodology used to generate the 17 other Procedures & Conditions ratings.
Home time.
Whether recovering from elective surgery or living with a life-threatening chronic condition, many patients value time spent living at home rather than in a healthcare facility. Guided by a growing body of research examining risk-adjusted “home time” as a patient-centered outcome measure, we introduced this measure in certain Procedures & Conditions ratings this year.
Outpatient and skilled nursing facility encounters.
We expanded our use of data from encounters occurring in non-inpatient settings. For example, in our new Prostate Cancer Surgery rating, surgeries that occurred in a hospital’s outpatient department counted toward the hospital’s volume. In our Stroke rating, inpatients who had received reperfusion therapy in another hospital’s emergency department before being transported and admitted were counted toward the admitting hospital’s performance on a reperfusion therapy process measure. Data from outpatient and skilled nursing facility encounters were used to define home time. And SNF data were also used in determining which patients were discharged to home.
Obstetrics & Gynecology.
The Obstetrics & Gynecology ranking, previously labeled Gynecology, has a new measure of hospitals’ public transparency. Hospitals received credit for the new measure if they or a nearby affiliated maternity hospital submitted data via U.S. News’ 2022 Maternity Services Survey. The data submitted via that survey will be used to produce the 2022-2023 Best Hospitals for Maternity later this year.
Transparency.
A separate measure of public transparency has been incorporated into the TAVR ratings. To receive credit, a hospital had to have voluntarily opted to publicly report via the STS/ACC TVT registry, which is maintained by the Society of Thoracic Surgeons and the American College of Cardiology. This registry began public reporting in 2022.
Low-value care.
Overtreatment and low-value care may cost the U.S. healthcare system more than $100 billion per year. This year, we added measures of low-value care in the Knee Replacement and Stroke ratings. In each of those cohorts, a hospital that performed poorly on the relevant low-value measure could not receive a high performing rating. The measures were calculated for U.S. News by the Lown Institute, a nonpartisan think tank.
Definitional refinements to key cohorts.
Based on clinician and hospital comments, exclusion criteria were added to make certain patient cohorts more clinically meaningful or homogeneous. For example, visits involving a principal diagnosis of catheter-associated urinary tract infection, or CAUTI, were excluded from the analysis that produced the Urology rankings. Visits with central-line-associated bloodstream infection were excluded from the Cardiology & Heart Surgery ranking. And both types of healthcare-associated infections were excluded from Geriatrics. In addition, visits involving cardiac arrest or cardiogenic shock were excluded from the Heart Attack cohort.
Expert opinion.
As previously announced, expert opinion scores were determined differently than in the past, in two respects. First, we conducted our physician survey exclusively online, using the Doximity platform to reach doctors who are users of that network, which includes more than 80% of doctors nationwide. Second, we handled a nomination differently if it came from a physician who had a current affiliation with the hospital they nominated, as compared to a nomination coming from a physician who was currently unaffiliated with the nominated hospital. To ensure the integrity of the physician survey, limited methodological detail about this new adjustment will be made available.
Best Regional Hospitals.
To be recognized as a Best Regional Hospital this year, a hospital had to (a) provide general medical and surgical services, (b) receive at least seven high performing ratings across the 20 Procedures & Conditions or a national ranking in at least one of 11 data-driven adult specialties, and (c) receive at least three more high performing ratings than below average ratings across the Procedures & Conditions. In determining the Best Regional Hospitals, each hospital’s performance in Aortic Valve Surgery and TAVR were combined into a single rating, and Ovarian Cancer Surgery and Uterine Cancer Surgery were combined into a single rating. Nationwide, 494 hospitals were identified as Best Regional Hospitals, compared to 531 last year.
Equity.
While not yet a factor in determining the Best Hospitals rankings, measures of health equity are a growing component of the U.S. News hospital quality reporting program. Starting July 26, hospitals’ profiles on usnews.com will feature measures of racial disparities in unplanned readmission, a measure of how much charity care each hospital provides, and a measure of how well low-income patients are represented among the patients each hospital serves. These new measures expand on the portfolio of health equity measures we debuted last year.
We welcome constructive input from patients, family members, clinicians, hospital leaders and other healthcare stakeholders. The ongoing U.S. News Healthcare of Tomorrow event series is open to all and provides a forum for dialogue on diverse topics, including the methodology behind the Best Hospitals rankings and ratings.
The 2022-2023 Best Hospitals methodology was developed and implemented by Zach Adams, Tavia Binger, Harold Chen, Avonelle K. Davis, Katherine Hilton, Ruoyu Ji, Neal Kar, Kelsey Lu, Min Hee Seo, Meera Suresh, Chelsey Wen and colleagues at RTI International. Asma Adimi, Carizma Forbes, Syeda Maliha and Olivia Thomson contributed to data collection. Kaylan Ware contributed to data collection and validation.
Originally published by U.S. News Second Opinion blog on June 29, 2022 at 11:47am. https://health.usnews.com/health-news/blogs/second-opinion/articles/2022-06-29/whats-new-in-this-years-best-hospitals-methodology
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