Reputation still skews hospital assessments

Correction: This story erroneously implied U.S. News changed its methodology in direct response to the Health Affairs study; the change was in fact announced before the study's publication. The wording has been clarified.

Hospital reputations play an outsized role in both quality assessments and day-to-day operations, experts told Becker's Hospital Review.

For example, when organizations negotiate managed care contracts, "[i]t's a lot easier at a prestigious hospital than it is at a community hospital, even if your outcomes are as good, and that's disappointing," Bill Bithoney, M.D., former chief of general pediatrics primary care at Boston Children's Hospital, told Beckers.

A January Health Affairs study found that hospital reputations have little bearing on care quality, even though more prestigious, higher-priced providers are more likely to appear in ranking lists, such as U.S. News & World Report's Best Hospitals. Earlier that month, U.S. News announced changes in its methodology to put less emphasis on reputation and more on patient safety.

"I gather that U.S. News has been refining their methodology (including changes since my article was written), and they're obviously trying to move away from relying on reputation reporting," Chapin White, Ph.D., the study's coauthor, told Becker's.

The shift away from reputation is deliberate, Ben Harder, managing editor and head of U.S. News' healthcare analysis team, told Becker's, although he denied that the old measurement system was "largely" based on reputation. "At some point, reputation may be completely removed from the Best Hospitals methodology," Harder said.

U.S. News is not the only institution placing more emphasis on safety and outcomes. Last week, Consumer Reports released rankings of the safest and least safe hospitals in the country, FierceHealthcare previously reported.

More prestigious hospitals will naturally get more notice, but community hospitals are just as capable of responding to individual patient needs, Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, told Becker's.

"If we've got a fairly routine thing that's the matter with us…that can be done superbly in a community hospital," Foster said. "If you're going in for a gallbladder removal, you're going in to deliver a baby … they know how to do that, and they can do it well. That comes with repetition."

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