How did the 2025 US News best hospitals perform on the Lown Index?
US News & World Report just released their list of “best hospitals” for 2025-26, which is based primarily on patient outcomes for complex specialty care and common procedures.
The Lown Hospitals Index for Social Responsibility takes a different approach to hospital ranking, evaluating hospitals on metrics of equity and value as well as outcomes.
What happens when you run the US News best hospitals on the Lown Index? Here are the key takeaways:
- Only four of the 20 US News best hospitals got “A” grades on the Lown Index for Social responsibility.
- Most of these hospitals did well on outcomes and value, but fell short on equity metrics, and especially struggled on pay equity and community benefit.
- Rush University Medical Center and the Mount Sinai Hospital in NY were the only hospitals on the US News list to make the Lown Index Honor Roll, by achieving “A” grades across the three main categories of equity, value, and outcomes.
Lown Index grades for US News best hospitals
In order of Lown Index ranking
| Hospital | Social Responsibility | Lown Index Rank | Outcomes | Value | Equity |
|---|---|---|---|---|---|
| Rush University Medical Center | A | 25 | A | A | A |
| The Mount Sinai Hospital | A | 107 | A | A | A |
| UCSF Helen Diller Medical Center at Parnassus Heights | A | 368 | A | A | B |
| AdventHealth Orlando | A | 806 | A | B | B |
| The Johns Hopkins Hospital | B | 877 | C | A | A |
| Hospital of the University of Pennsylvania | B | 937 | A | A | C |
| Mayo Clinic Hospital, Saint Marys Campus | B | 966 | A | A | C |
| Hackensack University Medical Center | B | 978 | A | A | C |
| Massachusetts General Hospital | B | 986 | A | A | C |
| Cleveland Clinic Main Campus | B | 987 | A | A | C |
| Tisch Hospital | B | 1020 | A | A | C |
| Ronald Reagan UCLA Medical Center | B | 1021 | A | A | C |
| New York-Presbyterian Hospital | B | 1026 | A | A | C |
| University of Michigan Health System | B | 1057 | A | A | C |
| Brigham and Women’s Hospital | B | 1066 | A | A | C |
| Houston Methodist Hospital | B | 1621 | A | B | C |
| Northwestern Memorial Hospital | B | 1706 | A | A | D |
| Mayo Clinic Hospital, Phoenix | B | 1708 | A | A | D |
| Stanford Hospital | B | 1715 | A | A | D |
| Cedars-Sinai Medical Center | B | 1805 | A | A | D |
Among the 20 hospitals on the latest US News Best Hospitals honor roll, most received “A” grades on outcomes and value on the Lown Index. But only three received “A” grades in equity, which brought down the overall social responsibility grade to a “B” for most of these hospitals.
There were some notable exceptions. Rush University Medical Center and Mount Sinai Hospital in NY both received all “A” grades, earning them a spot on the Lown Index Honor Roll.
“Our CEO is consistent in calling out structural racism as a public health emergency and one of the forces we have to take on. That cascades throughout the organization,” said John Rich, Director of Rush BMO Institute for Health Equity, at the Lown Institute’s Social Responsibility launch event.
What drives lower equity grades for these hospitals?
Why do so few hospitals on the US News list excel on equity? On the Lown Index, the equity grade has three metrics: pay equity, which measures how much the hospital pays their CEO compared to housekeeping workers; community benefit, which measures how much the hospital spends on financial assistance and community health initiatives, and their service of Medicaid patients; and inclusivity, which measures how well the hospital serves patients from lower-income neighborhoods and communities of color.
Many of these hospital CEOs are paid millions, driving low pay equity grades. For example, the CEO of Tisch Hospital in New York City was paid nearly $23 million in 2023. Some have high “fair share deficits,” meaning they gain much more in tax exemptions than they give back to their community. For example, the Hospital of the University of Pennsylvania only reported spending $8 million on financial assistance and community investment, while they received more than $250 million in tax breaks.
About half of the US News hospitals perform well on inclusivity, showing that they generally serve patients with a similar demographic makeup as their surrounding community. But many others fall short in serving patients from lower-income or lower-education areas, or from communities of color. Part of this is due to patterns of segregation within urban hospital markets, which are driven by decades of residential segregation and inequalities in payment rates for patients with public vs private insurance.
But hospitals can still have an impact on inclusivity, by crafting generous and well-implemented financial aid policies, avoiding “VIP” programs or other policies that treat wealthier patients differently, and opening clinics and outpatient centers in underserved areas.
Delivering high-quality care is the top priority for every hospital, and those on the US News Best Hospitals list appear to be doing a great job on that measure. But we think the bar should be higher for these hospitals, which include some of the wealthiest and most prestigious in the country. If all of these hospitals rose to the level of the very best, and provided accessible, affordable, and high-quality care to everyone who needed it, think of how much healthier our communities would be.