How do academic medical centers perform on the Lown Index?
The Lown Institute recently released the 2023 Lown Hospitals Index, naming the most socially responsible hospitals in America. The Index measures traditional metrics like outcomes and patient safety while adding new metrics like racial inclusivity, pay equity, and community investment to create a holistic evaluation of social responsibility.
Academic Medical Centers (AMCs) are affiliated with medical schools and tend to be larger, well-resourced institutions. How do they perform on the Index? Let’s take a look…
Strong on outcomes and value
It’s not a secret that AMCs tend to have better patient outcomes compared to non-teaching hospitals, for both common and rare conditions. On the Lown Index, AMCs rank higher than their non-teaching peers on both clinical outcomes, although they perform about the same on patient safety and worse on patient satisfaction, on average (see table below). Only five AMCs received a “C” grade in clinical outcomes, and none received a “D” grade.
Besides clinical outcomes, AMCs also shine on avoiding overuse and cost efficiency, with more than half of AMCs receiving “A” grades on these metrics. AMCs have the advantages of academic affiliation and resources, allowing them to become hubs for clinical trials and physician training. Research from February suggests this may impact their success, as they’re able to recruit talent, share staff with nearby community hospitals, and coordinate care for patients with various needs.
| Metric | AMCs, average rank (n=209) | non-AMCs, average rank (n=3,717) |
|---|---|---|
| Clinical Outcomes | 1,355 | 1,872 |
| Patient Safety | 1,008 | 1,140 |
| Patient satisfaction | 1,952 | 1,673 |
| Overuse | 778 | 1,353 |
| Cost Efficiency | 1,028 | 1,867 |
Equity is the missing piece
However, where some AMCs fall short is equity. AMCs still rank slightly better on average in community benefit and inclusivity compared to non-AMCs, but they don’t do as well on these metrics as they do on most of the outcomes and value ones. Around 50 AMCs get “A” grades on community benefit or inclusivity, compared to about 100 that receive “A” grades on clinical outcomes.
AMCs have especially poor rankings on pay equity, which may reflect the trend of high CEO pay at these hospitals. Given the great performance across other metrics, perhaps the high CEO pay is warranted. Many other hospitals also highly compensate their CEOs and do not deliver on social responsibility.
| Equity Metrics | AMCs, average rank (n=209) | non-AMCs, average rank (n=3,717) |
|---|---|---|
| Pay equity | 3,243 | 1,889 |
| Community benefit | 1,683 | 1,902 |
| Inclusivity | 1,592 | 1,778 |
AMCs that do it all
It’s not easy to perform well on outcomes, value, and equity, but there are AMCs that have proven they can do it all. Four AMCs made our honor roll, meaning they earned A’s across all three of those metrics. Here are the top ten AMCs.
Top 10 Academic Medical Centers, Social Responsibility
| Top 10 AMCs | Hospital | Equity Grade | Value Grade | Outcomes Grade |
|---|---|---|---|---|
| 1 | St. Luke’s University Hospital – Bethlehem Campus (Bethlehem, PA) | A | A | A |
| 2 | Denver Health Medical Center (Denver, CO) | A | A | A |
| 3 | MedStar Washington Hospital Center (Washington, DC) | A | A | A |
| 4 | HCA Florida Osceola Hospital (Kissimmee, FL) | A | A | A |
| 5 | VCU Medical Center Main Hospital (Richmond, VA) | B | A | A |
| 6 | Baylor University Medical Center (Dallas, TX) | B | A | A |
| 7 | UCHealth University of Colorado (Aurora, CO) | B | A | A |
| 8 | RUSH University Medical Center (Chicago, IL) | B | A | A |
| 9 | OHSU Hospital and Clinics (Portland, OR) | B | A | A |
| 10 | UC Davis Medical Center (Sacramento, CA) | B | A | A |
Learn more about the Index and see how your hospital performed by visiting our website.