Cincinnati Children's takes Boston Children's spot at top of US News' contentious ranking

Cincinnati Children’s Hospital Medical Center has dethroned Boston Children’s Hospital in the latest release of U.S. News & World Report’s highly watched—and now frequently criticized—Best Children’s Hospitals rankings.

Boston Children’s had held the top spot of the annual rankings for nine years running, and for 2023-24 the hospital is still top-ranked for three measured specialties: gastroenterology and GI surgery, diabetes and endocrinology (tied), and neurology and neurosurgery.

Cincinnati Children’s, however, was the beneficiary of methodology refinements that put less weight on expert opinion and more emphasis on measures related to best practices and equity, diversity and inclusion, according to U.S. News & World Report. Alongside its place as the top overall children’s hospital, Cincinnati Children’s was also in the lead for cancer, diabetes and endocrinology (tied), neonatology and urology.

“We are incredibly proud and honored to be recognized as the best pediatric hospital in the nation,” Steve Davis, M.D., president and CEO of Cincinnati Children’s, said in a release. “This distinction only confirms what we have always known—that we have outstanding, talented team members who are unmatched in their dedication to ensuring that all children have access to exceptional care."

The full 2023-24 U.S. News Best Children's Hospitals honor roll is as follows:

  1. Cincinnati Children’s Hospital Medical Center
  2. Boston Children’s Hospital
  3. Texas Children’s Hospital, Houston
  4. Children’s Hospital of Philadelphia
  5. Children’s National Hospital, Washington, D.C.
  6. Nationwide Children’s Hospital, Columbus, Ohio
  7. Children’s Hospital Los Angeles
  8. UPMC Children’s Hospital of Pittsburgh
  9. Rady Children’s Hospital, San Diego
  10. Johns Hopkins Children’s Center, Baltimore

Other leaders within the specialty categories included Texas Children’s Hospital, which led the cardiology and heart surgery, nephrology, and pulmonology and lung surgery measures; and Children’s Hospital of Philadelphia, which led for orthopedics.

“Parents of sick children face many difficult challenges, including how to identify the best children’s hospital to treat their illness or condition," Ben Harder, chief of health analysis and managing editor at U.S. News & World Report, said in a release “The rankings, which are increasingly determined by objective measures of hospital quality, can help them make informed decisions.”

Built by U.S. News and research firm RTI International, the annual ranking includes operational and outcomes data from 199 facilities as well as opinion surveys with thousands of expert physicians.

However, the organization’s list is under increased scrutiny this year.

Tuesday, San Francisco City Attorney David Chiu sent a letter to U.S. News requesting additional information on its ranking methodology and demanding that the organization publicly disclose any payments it receives from endorsed hospitals for use of its “best hospitals” badge in marketing materials. The attorney also noted that the outlet’s process offers limited opportunity to smaller hospitals and can incentivize hospital investment into conditions experienced primarily by white people.

“The hospital rankings appear to be biased towards providing treatment for wealthy, white patients, to the detriment of poorer, sicker or more diverse populations,” Chiu said. “Perverse incentives in the rankings risk warping our health care system. Hospitals are treating to the test by investing in specialties that rack up the most points rather than in primary care or other worthy specialties.”

Chiu’s claims echo those penned by Seattle Children’s pediatricians Madeline Wozniak, M.D., and Chinenyenwa Mpamaugo, M.D., who wrote in Health Affairs about how cystic fibrosis, which affects about 35,000 primarily white people in the U.S., outweighs measures for sickle cell disease, which affects one in 365 Black newborns but extremely few white newborns.

Recent months have also seen a widespread exodus of leading institutions from U.S. News’ annual rankings of medical schools and law schools. Hospital rankings have yet to see a wave of pull-outs, with the exception of St. Luke’s University Health Network in Pennsylvania.