Just what does a hospital’s ranking mean, anyway?

Each March, I watch for rankings and seeds leading basketball teams into the NCAA tournament bracket. These rankings rely on a specific metric designed by the NCAA. I always wonder at the way just a slight change in that metric could determine the fate of a basketball team … now imagine how it can determine the fate of patients and hospitals seeking expert care. This article from US News shows just how tricky it can be to rank a hospital.

– Eric

Our Methodology: How We Ranked the Best Hospitals in 52 Metro Areas

Factors include a hospital’s breadth of expertise and whether it’s among the nation’s best

Atlanta’s Emory University Hospital is among the nation’s elite medical centers. It is one of only 152 of the country’s 4,852 hospitals to be named a U.S. News Best Hospital in even a single specialty in the 2010-11 national rankings. And while most of the 152 are ranked in just a few of the 16 specialties that Best Hospitals covers, Emory is ranked in 11.

Fifteen minutes away, on the other side of the Northeast Expressway, Piedmont Hospital is less well known. Nevertheless, it is among the best hospitals in the Atlanta area. Newly expanded U.S. News rankings of hospitals in the 52 most-populous metropolitan areas show that, in 11 specialties, Piedmont offers Atlantans high-quality care. In those specialties, which include cancer, cardiology and heart surgery, and orthopedics, its performance puts it above most other hospitals that are not nationally ranked.

[See Best Hospitals by Metro Area.]

Piedmont is among 622 metro-area hospitals now recognized by U.S. News.

The new rankings, the largest expansion of Best Hospitals to date, offer patients and their families a much better chance of finding a top-performing hospital in their health insurance network. And for patients who would need to travel to visit a nationally ranked hospital, the metro rankings may offer a local alternative—or several.

Some patients need every bit of skill medicine has to offer—to operate successfully on an invasive brain tumor or to remove a portion of the delicate pancreas, for example. But while such patients number in the millions, they represent a small percentage of hospital admissions. The metro rankings were created for the majority of patients, whose care may not demand the special expertise found at a nationally ranked Best Hospital. The added centers boast a strong record of high performance for most conditions and procedures in one or more specialties.

The new rankings derive from the Best Hospitals methodology and data that produced the 2010-11 national rankings. All of the 4,852 U.S. hospitals were whittled down to much smaller groups by specialty—898 in cancer and 1,598 in orthopedics, for instance—that met stringent benchmarks such as a minimum number of certain types of serious cases. The top 25 percent of hospitals in each specialty that met those standards were identified, using the scoring methods employed in the national rankings. Out of those 25 percent, hospitals within metropolitan areas with populations of 1 million or more were ranked in their metro area.

The rankings were ordered first by a hospital’s number of nationally ranked specialties and then by the number of other specialties in which it was among the top 25 percent nationally. A hospital’s ranking within a specialty did not play a part; a No. 1 national ranking in urology carried no more weight than a No. 35, for instance.

Within a metro area, a hospital that is nationally ranked even in one specialty was listed above others that are high-performing in multiple specialties but not nationally ranked in any of them. This way a patient who might need the type of care in which the nationally ranked hospital excels will be less likely to overlook it in favor of a hospital with broader but shallower expertise.

Consequently, the No. 1 hospital in a metro area is not necessarily the best in town for all patients. Other hospitals may outshine it in various specialties. We expect that savvy consumers will consider not merely a hospital’s overall rank in the metro area, but its expertise in the specialty relevant to their care.

Of the 152 nationally ranked Best Hospitals, 132 are in one of the selected metro areas. In addition to those 132, the metro area rankings include 490 other centers that are in the top 25 percent in one or more specialties.

Several hundred hospitals scored in the top 25 percent nationally in one or more specialties but are not in one of the selected metro areas. While not ranked, these hospitals are recognized on their U.S. News Web page as high-performing in those areas of care.

Children’s hospitals are not included in the new rankings; few metro areas have more than one or two, making consumers’ decisions easier.The metro-area rankings will be updated in July 2011, when the 2011-12 national rankings are published online.

About thebenefitblog

Eric is a Producer at Lockton Insurance Brokers, Inc., the world’s largest privately held commercial broker. Eric has over 23 years of experience in the insurance industry and has spent the last 11 years with Lockton. Eric specializes in Health & Welfare Benefits, Retirement Planning, and Executive Benefits. Eric's clients utilize his expertise in the areas of Plan Due Diligence, Transaction Structure, Fiduciary Oversight, Investment Design, Compliance and Vendor negotiation to improve the operational & financial outcome for each client. The Benefit Blog is a place to share that expertise and industry news.
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