What is the Lown Hospitals Index?
The Lown Institute Hospitals Index is the first ranking of hospital social responsibility, by evaluating hospital performance on health outcomes, value, and equity.
A lot of hospital rankings exist already. Why do we need another one?
Most hospital rankings focus solely on patient outcomes, but hospitals do more than just provide medical services. Hospitals make decisions every day that impact the health and well-being of their community, such as how they invest in community health initiatives, who they welcome into the hospital, and how much they pay their workers. The Lown Institute Hospitals Index is the first ranking to take these factors into account, in a holistic measure of social responsibility. Read more about why we took this project on.
Who is the Lown Index for?
The Lown Index shows how well hospitals serve communities, as well as individual patients. We think this is something that everyone should be interested in, especially policymakers, hospital administrators, community health advocates, and other actors seeking to enact health system change in their communities or institutions.
How are the stars and grades calculated?
For each detail (eg. racial inclusivity, charity care), hospitals receive between 1-5 stars and a ranking. The stars reflect the actual result of hospital performance on a metric, not just their performance relative to other hospitals; many hospitals may get 5 stars on a metric if they all have similar (and good) results.
The respective detail scores are weighted to create grades and rankings for each component (eg. inclusivity, community benefit). Each hospital gets a grade rating: A (highest) to D (lowest). Hospitals within the top range of scores (approximately the top 25%) get an A, the next 40% get a B, the next 20% get a C, and the last 15% get a D. These component grades are then weighted to create grades for each category (equity, value, and outcomes).
Finally, an overall Social Responsibility grade is assigned based on the weighted grades from value (30% weight), equity (30%) and outcomes (40%).
Why did my hospital not receive a composite grade?
Some very small hospitals did not have enough patient stays to reliably calculate their outcomes, cost-efficiency, or avoiding overuse scores (698 hospitals). These hospitals were were not given a composite score, but were still graded on the components for which data were available.
Why is my hospital missing from the Index?
The following types of hospitals are excluded from the Index:
- Hospitals outside the 50 US states and Washington, DC
- Hospitals that are not included in Medicare fee-for-service data (such as children’s hospitals and Kaiser Permanente hospitals)
- Federally-run hospitals (such as VA Hospitals)
- Specialty hospitals (such as orthopedic hospitals). We defined specialty hospitals with more than 45% of their cases in orthopedics, cardiac care, or surgeries.
- Hospitals that were closed in 2020. We determined closed hospitals through a check of Hospital Compare, a website run by CMS.
See the methodology paper for more details.
My hospital is part of a system but doesn't appear in the system list. Why is that?
Some hospitals were excluded from our rankings (see above). Only hospitals that were ranked are included in our system rankings. In addition, systems membership is based on 2018 American Hospitals Association records and may not reflect current membership.
