The University of Pennsylvania Health System will no longer participate in the U.S. News & World Report’s annual ranking of hospitals, officials announced Monday. The decision by the perennially highly ranked health system, part of Penn Medicine, added to a growing revolt against the lists by prominent schools.
The university’s medical and law schools previously had announced that they would no longer cooperate with U.S. News on the lists.
Last fall, Heather K. Gerken, the dean of Yale Law School touched off a rebellion against the influential rankings when she announced the school would no longer participate in a system she called profoundly flawed. Within hours, Harvard University’s law school stepped away as well, to be followed by dozens of other top law schools. Many of the deans expressed concerns that the rankings relied on metrics that played against their own core commitments, such as supporting students with financial aid.
In January, many top medical schools walked away from the rankings. Harvard Medical School’s dean, George Q. Daley, wrote in a message to the school that the ranking system creates “perverse incentives for institutions to report misleading or inaccurate data,” among other concerns.
Several undergraduate programs, including Columbia University, have also declined to participate.
The Hospitals of the University of Pennsylvania-Penn Presbyterian have been included in the U.S. News “Honor Roll” — the publication’s Top 20 lists of hospitals — for the past 16 years.
Eric Gertler, executive chairman and chief executive of U.S. News, said in a statement that the hospital rankings “provide an important journalistic and public service to individuals and families making critical decisions about medical care for themselves or their loved ones. We have continually stated that rankings should be one factor in that decision-making process, as any medical decisions should be made in consultation with a physician.”
Penn Medicine officials criticized the ranking’s emphasis on inpatient care of people on Medicare. The majority of treatment at Penn Medicine happens outside of the hospital. Half of chemotherapy and medical infusions are done at home, Mahoney said. “We’re really proud that a cancer patient can sit in his or her chair, have their dog with them, watch a show on TV,” while getting treatment, he said — but that kind of innovation isn’t reflected in the rankings.
Gertler wrote that the methodology evolves each year to reflect changes in health care and in response to clinicians, hospital leaders and others. This year’s rankings, he noted, will be the first to include measures of patient outcomes following outpatient surgeries, reflecting the growing role of outpatient care.
Penn Medicine officials acknowledged that U.S. News may continue to rank its hospitals, but they said it will no longer participate in the process or promote the results.
It’s expensive to participate, Mahoney noted; hospitals pay U.S. News for the right to use the “badges” listing them as a top hospital in their marketing. “As a nonprofit, should I be sending so much money to someone over our rankings?” he said. “As opposed to spending it to further our mission.”
The San Francisco City Attorney David Chiu sent a letter to U.S. News earlier this month expressing concerns about the company’s methodology for ranking hospitals and asking the company to disclose how much revenue it receives from hospitals it endorses.
A spokeswoman for U.S. News said the company “categorically disagrees with the assumptions and conclusions in the City Attorney’s letter. U.S. News is the leading trusted source for quality hospital rankings precisely because we do not in any way accept or engage in compensation for rankings placement.”
The health system will create a public dashboard with more comprehensive data than U.S. News collects, Penn Medicine announced, including measures such as readmission and infection rates and data on areas such as virtual and home care. The system hopes to work with other health systems nationally to devise standardized quality and performance measures.
The data for the rankings that come out this summer were already submitted, Mahoney said. Next summer, he expects their ranking will probably plummet. “That’s okay,” he said. “I just wanted everyone in my organization to stop talking about it.”