U.S. News named America’s “best hospitals.” Here’s how they score on the Lown Index.

U.S. News & World Report released its latest Best Hospitals Honor Roll this summer, celebrating 20 of the nation’s most famous medical centers. On the Lown Hospitals Index, which measures how well hospitals serve their communities, most of them rank nowhere near the top.

Every year, the release of the U.S. News & World Report Best Hospitals rankings is a highly anticipated event on the healthcare calendar. Hospitals that make the national Honor Roll put it on billboards, feature it in print collateral, and share it across websites and socials. This year’s edition names a familiar 20 hospitals to that Honor Roll, holding them up as representative of what is “best” in American medicine. 

While the U.S. News ranking is heavily weighted toward clinical outcomes and specialty care, the Lown Institute ranking is more expansive. In addition to clinical outcomes measures, it includes measures of value and health equity, with the latter category being weighted slightly heavier than the others. So we looked up where each of this year’s 20 U.S. News honorees lands on the current Lown Hospitals Index for Social Responsibility, which evaluates more than 2,700 acute-care hospitals.

The results are striking.

Of the 20 hospitals U.S. News calls the nation’s best, only two, Johns Hopkins and Mount Sinai, rank inside the Lown top 200. Just six crack the top 500. Fourteen fall outside the top 1,000 altogether. The median U.S. News honoree comes in around 1,060th on social responsibility.

Why the “best” hospitals fall short

To be clear, these are outstanding hospitals. Many are world leaders in complex, specialized care, and that holds up in our data too. Look at how they score across the three pillars of the Lown Index:

On patient outcomes, all 20 earn an A. On value, all but one do. Where they consistently stumble is equity, the measure of how well a hospital serves everyone in its community, including lower-income and non-white patients. Equity captures things like whether a hospital’s patient population reflects the diversity of the area around it, how it invests in community health, and how fairly it pays its workers. Fourteen of the 20 earn a C or D on equity.

That gap is what sends these celebrated institutions tumbling down the Lown ranking. A lens built on clinical prestige and specialty depth, like the U.S. News ranking, isn’t designed to credit hospitals for their social responsibility like the Lown Index is.

Prestige and social responsibility can go together

This isn’t a matter of one ranking being right and the other wrong. The two measure different things. U.S. News asks where the most advanced clinical care is delivered. The Lown Index asks how responsibly a hospital serves its whole community. Both questions matter.

And they are not mutually exclusive. Johns Hopkins (69th) and Mount Sinai (114th) earned straight A’s across equity, value, and outcomes—earning them spots on the Lown Honor Roll, a group of just 123 hospitals nationwide this year, in addition to their status as U.S. News Best Hospitals. These examples prove that clinical excellence and social responsibility can absolutely coexist. Most of their celebrated peers simply haven’t gotten there yet.

Redefining what “best” means

For decades, “best hospital” has been defined largely by reputation and clinical firepower. But patients, employers, payers, and communities are increasingly asking a broader set of questions: Does this hospital serve everyone in the community? Is its care worth what it costs? Does it invest in the people and neighborhoods around it?

By those measures, which increasingly define what is most important to Americans, the U.S. News Honor Roll falls short of the full picture. The most prestigious address is not always the most responsible one. And a fuller, fairer definition of “best” is exactly what the Lown Hospitals Index was built to provide.

See how your hospital scores on equity, value, and outcomes at lownhospitalsindex.org.