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U.S News Announces Methodological Changes to Upcoming Annual Update of Best Hospitals Ranking and Ratings

U.S. News will publish its annual update of the Best Hospitals rankings and ratings on July 28th. The data for over 4000 hospitals used in the 2020-21 edition of Best Hospitals come from a period predating the COVID-19 pandemic and were not affected by the pandemic’s impact on hospitals.

Methodological revisions in this year’s updated rankings will include:

  1. TAVR cohort – a new rating that measures the quality of hospitals’ transcatheter aortic valve replacement (TAVR) programs. The TAVR rating has been factored into the calculation of the Best Regional Hospitals and Honor Roll rankings.
  2. Stroke measure – a new risk-adjusted outcome measure of stroke within 30 days of a TAVR procedure.
  3. Knee outpatient volume – In calculating hospitals’ volumes for the Knee Replacement rating, outpatient knee replacement procedures performed from Jan. 1, 2018, through the end of the December 2018 (the first appearance of outpatient Medicare claims) is used.
  4. Medicare Advantage adjustment – switching to a hospital-level Medicare Advantage (MA) adjustment factor from the county-level adjustment factor used in prior years. The new hospital-level factor was developed by creating a ratio of each hospital’s total MedPAR volume to their fee-for-service (FFS) MedPAR volume.
  5. Transparency – incorporating a Transparency measure into Neurology & Neurosurgery based on a hospital’s public reporting status in the American Heart Association’s Get With The Guidelines-Stroke program.
  6. Discharge to home outcome measure includes patients who were discharged to home with planned readmission (discharge status codes 81 or 86) or who received nonsurgical care in any specialty or Heart Failure or COPD and who were subsequently discharged to home hospice (code 50) were treated as having been discharged to home.
  7. Time period – switching to using calendar-year Medicare data (specifically, three years’ worth of claims through December 2018) rather than fiscal-year data (claims through September 2018) in the specialty rankings.
  8. Best Regional Hospitals recognition changes – a hospital had to (a) provide general medical and surgical services, (b) receive at least three High Performing ratings across the procedures & conditions or at least one national ranking across the 12 data-driven adult specialties, and – in a criterion added this year – (c) receive at least two more High Performing ratings than Below Average ratings across the procedures & conditions. Nationwide, 563 hospitals were identified as Best Regional Hospitals, compared to 569 last year.
  9. Display of outcome performance in the 12 data-driven specialties on a scale of 1 (worst) to 5 (best), with a score of 3 indicating the hospital’s risk-adjusted performance is not statistically different from expected.

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