U.S. News & World Report is set to release its 2017-18 Best Hospitals rankings on Aug. 1, which will incorporate several methodology changes, the publication announced Wednesday.
The changes may result in hospitals receiving fewer high performing recognitions in the procedures and conditions ratings and may also affect hospitals' patient safety scores relative to last year.
The Honor Roll methodology, which was updated for 2016-17, will not change.
Here are 12 major methodology changes involving the specialty rankings, the procedures and conditions ratings and Best Regional Hospitals rankings.
Specialty rankings
1. U.S. News will no longer use PSI-6 (iatrogenic pneumothorax) and PSI-14 (postoperative wound dehiscence) in its patient safety score calculation, as "these two adverse events are so rare — fortunately for patients — that very few hospitals can be meaningfully differentiated by their rates," according to U.S. News.
2. The patient safety score will be based on the four remaining PSI measures and will receive a 5 percent weight in 12 specialties, just as it did in 2016-17. However, most hospitals will receive 2.5 out of 5 percentage points and will display a score of five out of nine for patient safety. Hospitals with PSIs that are two or more away from the standard deviation will have higher or lower patient safety scores.
"Many of the hospitals that last year received a high or low Patient Safety Score will be assigned an average score this year as a result of these methodology changes, even if their success in keeping patients safe did not change," U.S. News explained.
3. Specialty rating scores will be risk adjust for socioeconomic status using dual eligibility as a marker.
4. U.S. News will tweak its definition of transfer cases so hospitals will be rewarded for taking on more high-risk patients. Patients who were admitted to a hospital the same day they were discharged from another will not count from a hospital's survival score.
5. U.S. News will adjust volume in each specialty to account for regional differences in Medicare Advantage enrollment.
Procedures and conditions ratings
6. Five years of Medicare data will be used to calculate ratings, as opposed to three years in the past.
7. Discharge to home will be added as an outcome measure in both medical cohorts (heart failure and COPD) and procedural cohorts.
8. For the abdominal aortic aneurysm repair procedure ratings, U.S. News will measure risk-adjusted survival separately for open and endovascular procedures.
9. Hip replacement surgery and knee replacement surgery complication rates will be separated and adjusted for dual eligibility.
10. For heart failure ratings, hospitals can get credit for providing noninvasive ventilation and for having congestive heart failure programs.
11. Severity of disease will be incorporated into heart failure and COPD ratings.
Best Regional Hospitals rankings
12. U.S. News will place more emphasis on the procedures and conditions ratings and less on specialty rankings. "The shift reflects our judgment that patients looking for a hospital within their community are more likely to need the sort of care evaluated in those ratings than they do in the higher-complexity, higher-acuity care evaluated in the specialty rankings," according to the publication.
See U.S. News' full explanation of ratings and rankings methodology changes here.