Love them or hate them, the annual US News hospital rankings cannot be ignored. In many markets they not only define a hospital’s status among the public, but are also a performance metric driving bonuses in the hospital’s executive suite.

If you guide a clinical department or academic medical center and want to improve your organization’s US News position, start by understanding the rules by which they run their contest, and then figure out how to hack those rules … which you’ll quickly discover is not dissimilar to what you’re already doing.

The Rules

For clinical care of adults, US News generates scores for hospitals in 16 individual specialties to create its “Best Hospitals for Specialty” rankings. And while we focus on adult hospital ranking here, the rules for “Best Children’s Hospitals” ranking follow a similar process.

As shown at right, the US News score for 12 of 16 adult specialties derives from three main components:

  • Outcomes – primarily Medicare 30-day survival

  • Structure – various hospital data

  • Reputation – as measured by physician survey (recently re-branded as “Expert Opinion”)

Note that four specialty scores derive entirely from the physician survey reputation.

Outcomes and Structure are difficult to impact as they involve big, expensive, complicated metrics such as: patient volumes, mortality rates, major technology and infrastructure investments, transplant capabilities, a certified trauma center, Nurse Magnet status, etc. Given these challenges, Reputation becomes the focal point.

The Annual Survey

Conducted between January and March each year, the US News physician survey asks just one substantive question: “Please name up to 5 U.S. hospitals that in your opinion provide the best care in [Specialty] for patients who have the most challenging [etc.]” The votes tallied for this one question translate directly into the hospital’s Reputation score by specialty, and ultimately 24.5% to 100% of each overall specialty score (most are 27.5%).

From this, and from the survey-scoring mathematics explained here, some important details emerge:

  • It’s good to be big and/or famous: Outsized marketing presence, international fame, and a major metropolitan location all boost awareness and raise scores.

  • Turnout matters: Just as in presidential elections, it is critical to get out the vote. For example, a sizable base of loyal alumni who vote can raise scores.

  • It’s easier to stay on top: Survey results are weighted equally among the three prior years, thereby benefiting those institutions already ranked highly.

  • The numbers aren’t that big: For the 2019 rankings, 24,638 physicians completed the survey, yielding a mean of just 1,540 votes per specialty.

That 1,540 number is key. Because a few premiere, brand-named academic centers commandeer a large fraction of the votes, comparatively few votes remain to be split among all other hospitals. This graph shows how three or four institutions garner most of the vote and the next sixteen clustered tightly together, making the pathological sensitivity of the US News algorithm evident.

Ultimately, this graph illustrates the challenge and the opportunity. It may be impossible to place first in this contest, but climbing up four or five (or ten) places isn’t.

Hacking the Rules

Once you appreciate the challenge, the critical next step is to discard any hesitancy to hack the rules to optimize your ranking. Taking advantage of weaknesses or limitations in the US News methodology is neither immoral nor unethical. These scores are arbitrary quantities, not mapped to any definable concept in the real world, that are manufactured by a for-profit company. Yes, the scores do incorporate measures that are important in clinical care, but you are optimizing those already, according to the priorities of your institution. (Should a bunch of magazine editors and outside statisticians really be telling you what is important for your hospital and what is not?)

Next, understand that the single highest-yield path to elevating your US News rankings is to get physicians to vote for your institution in the survey. This may seem daunting, but recognize that:

  1. You’re already doing it – At some level or another, you are (or should be) creating awareness and promoting your department or medical center. Healthcare in the US is a market-driven, competitive landscape and that means communicating your value to the marketplace.

  2. US News voters are referring physicians – You know that promoting the accomplishments and expertise of your physicians drives patient referrals. It also drives survey votes: a “two-fer.”

  3. Modest success can mean a large impact – The compressed, low-number vote distribution means that a consistent, coordinated awareness campaign that incrementally increases your US News vote count can substantially improve your standings.

The fundamental “hack,” therefore, is the execution of an effective physician outreach strategy. It’s media and advertising, graphics and search-engine optimization and, increasingly, social media. It’s what highly ranked hospitals and clinics understand, and it’s what they are doing today.

Expertscape can help. We identify and objectively rank medical expertise – exactly the characteristics you want the world to know about your institution. And we’re a communication engine that can supercharge your marketing efforts by celebrating your expertise. Immediately. Affordably. Just contact us.

Contact us to learn more.