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. 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 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. More

“Hospitals are members of their communities, and when we think about them and when we try to understand what their performance is like, we wanted to be able to think about ways we might measure their participation or engagement ... in the community,” said Dr. Vikas Saini, Lown’s president and a cardiologist. “With the (coronavirus) pandemic, I think more than ever the idea that hospitals need to be real partners with their communities has become much clearer to a lot of people.” More

"What we are showing isn't news — there is a certain amount of inequity in healthcare," said Dr. Vikas Saini, president of the Lown Institute. "But what we have tried to do is paint this picture in a way that allows everyone to see it and all of us to think about how to do things better." More

“There are some very fine hospitals that feel forced to focus on profitable elective procedures to stay in business,” Saini explained. “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.” More

“Hospitals who do well with care, do not do well with civic engagement and equity,” said Brownlee, a former health care reporter for US News and World Report and Discover Magazine, and said she has been thinking about breaking down this type of data on hospitals for the better part of a decade. “If a hospital is good on inclusivity, then it means you are working harder to care for lower income people and people of color.” More

No previous hospital rankings use “civic leadership,” which includes community-minded policies such as charity care, financial aid, and paying all staffers a living wage, or “value of care,” meaning whether a hospital avoids 13 procedures of questionable or clearly absent clinical benefit. The Lown Institute, a nonprofit think tank in Brookline, Mass., incorporated both measures into its rankings of 3,282 hospitals because “it is time for hospitals to rethink what it means to be great,” said Lown’s president, physician Vikas Saini. More

If we want to start holding hospitals more accountable for improving their performance, however, we first need a reliable set of metrics to hold them accountable to. Unfortunately, those metrics don’t exist—not in government or the private sector. More