Who's on Lown Institute's list of most 'socially responsible' hospitals?

The second annual most socially responsible hospitals rankings are out from the Lown Institute.

The not-for-profit think tank takes into account readmissions and mortality, along with top executive compensation, charity care, community investments, cost efficiency and value of care.

Carepoint Health-Christ Hospital and Saint Michael's Medical Center in New Jersey, and Johns Hopkins Bayview Medical Center in Maryland topped the list overall as the most socially responsible out of 3,709 general acute care hospitals. Specialty hospitals with more than 45% admissions from orthopedic, cardiac, or surgical procedures were excluded.

Other top hospitals included Oroville Hospital in California, the University of Maryland Medical Center Midtown Campus in Maryland and UNM Sandoval Regional Medical Center in New Mexico.

Hawaii, Delaware and Washington, D.C. all had the highest average of the best ranked hospitals overall.

Additionally, about one-third of hospitals that ranked in the top 75 were located in California or Ohio, with many also located in New Jersey, Maryland and Tennessee. For-profit hospitals performed worse on average.

Arkansas, Mississippi and Alabama had the lowest average number of well-performing hospitals. Claiborne County Hospital in Mississippi ranked worst overall, receiving a C grade in equity, a D in clinical outcomes and patient satisfaction and another D in value, or how efficiently a hospital delivers care and avoids low-value services. The hospital is listed as having less than 50 beds, rural and a safety net provider.

Also included were the worst and best health systems. Not-for-profit Memorial Healthcare System in Florida came in dead last. Adena Health System in Ohio came in as #1.

This is the second year the Lown Institute has releases this ranking which takes into account 54 metrics across equity, value and outcomes. Primary data comes from 2016–2018 Medicare fee-for-service claims. It also uses data from SEC filings, IRS 990 forms and the U.S. Department of Labor to paint a picture of the role hospitals have in a community.

The rankings faced criticism in their first year, with hospital and quality leaders poking holes in the methodology. The Lown Institute made changes to how it calculated scores for 2021, but despite that the American Hospital Association said there are still issues. For instance, the inclusivity measure looks at Medicare data, which they say isn't representive of all patients within a hospital. In addition, mortality is balanced against cost determines the cost efficiency category, and the AHA said other metrics could be used.

"The new index from the Lown Institute draws sweeping and arbitrary conclusions about hospitals and health systems using old and incomplete data and flawed methodologies," an AHA spokesman said.

The Lown Institute has said that the rankings should start a dialogue around the work hospitals do and where they could improve.