How Much of an Impact do Hospital Rankings Really Have?

by webadmin on August 1, 2013

HRK-thumb1Every year, when U.S. News and World Report’s annual “Best Hospitals” list is released, the marketing departments for healthcare organizations that make the cut go into overdrive.

In a thought-provoking analysis for The New York Times, Elisabeth Rosenthal asks, “But what does this annual exercise mean for patients? And what does it say about American healthcare?”

She reminds readers that Harvard and Princeton make the same magazine’s annual Top 10 national universities list, yet neither school launches massive celebratory marketing campaigns as a result, since “they will fill their classrooms no matter.”

“And as in the college ratings, there are no big surprises in the top hospital group: they are the big academic medical centers — the Mayo Clinic, Massachusetts General Hospital, the Cleveland Clinic,” she continues, adding, “More to the point, even though you might well fly across the country for four years of schooling, you are far more likely to stay near your home for medical care. No one’s flying to Mayo in Minnesota to get inhalers for asthma, even though it ranks No. 1 for pulmonary medicine.”

Basically, she writes, it all comes down to the business aspect of American healthcare. Unlike many countries, where advertising by hospitals and physicians is forbidden, the American economy demands competition from its healthcare sector. As a result, the U.S. News list becomes another tool in the brand arsenal of hospital marketing departments.

This is understandable, of course. But experts have found that rankings and promotional drives have little impact on patients.

Dr. Nicholas Osborne, a Robert Wood Johnson Clinical Scholar at the University of Michigan, explains, “Nearly every hospital has a banner out front saying they’re a ‘top hospital’ for something in some rating system. Those ratings have become more important for hospital marketing than for actually helping patients find the best care.”

The ratings themselves are confusing, Osborne continued. U.S. News and Healthgrades  both rank hospitals and both “come up with completely different lists. What does that tell you?”

…Especially when larger hospitals are averaging $2.18 million on advertising each year in a system that already spends one-third of its $3 trillion healthcare bill on waste.

Then, there’s the larger question, Rosenthal writes. Isn’t accurately rating a hospital more complicated than simply reading off the numerical placements of the Top-40 hits a la Casey Kasem? “For one thing, hospitals that take on sicker patients might have more complications after surgery.”

Advertising also encourages fraud, Robert Steinbuch, a professor of law at the University of Arkansas at Little Rock, cautions. “If they advertise cardiac care and don’t have angioplasty, that’s essentially fraud…[If a patient dies,] that could be considered criminally negligent homicide.”

Rosenthal concludes her piece by clarifying that advertising will never go away. Furthermore, she writes, this isn’t meant to dismiss rankings entirely. After all, “even skeptics concede healthcare ratings, when properly developed and employed, may help hospitals improve their performance and provide patients with valuable information.

“If you have a rare lung condition that has flummoxed local doctors, for example, you may want to fly to Mayo since U.S. News has ranked it No. 1 in pulmonary medicine. And if a dozen hospitals in your area offer hip replacements, a search of regional rankings on the magazine’s website will yield some useful statistics.”

“But,” she adds, “take all those hospital advertisements with a grain of salt.”

As healthcare leaders, what are your thoughts on hospital rankings? How much stock should patients put in them? How does your organization handle its advertising and marketing?

-by Pete Fernbaugh

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