Who is the Lown Index for?

The Lown Hospitals Index is a valuable resource for policymakers, researchers, hospital leaders, clinicians, journalists, community leaders, and all citizens who believe socially responsible hospitals are important. The rankings have been used to showcase hospital performance, identify key areas of improvement, and enact health system change in communities or institutions.

How can I share my hospital's performance?

Visit our hospital resources page where you can:

• See examples of how other hospitals have shared their recognition
• Access our press release templates
• Contact us about your eligibility for our badge licensing program

Is Lown Hospitals Index data available to purchase?

Yes. Hospital and system level data is available for purchase and can be customized to your specifications. Complete a Data Access Application or contact index@lowninstitute.org for more information. Additionally, our rankings, grades, and hospital characteristics data are available for download for free on the Rankings page. 

What is the Lown Hospitals Index?

We believe a socially responsible health system is possible, but to get there, we have to measure what matters. The Lown Hospitals Index produces data-driven metrics of equity, value, and outcomes, giving hospitals the information they need to improve, and empowering communities to hold them accountable. As the first ranking for hospital social responsibility, we strive to measure everything that matters to patients and communities—and we’re improving the Index each year.

A lot of hospital rankings exist already. Why do we need another one?

Hospitals are essential care providers and lifelines for complex and emergency care in their communities. However, 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, including novel metrics like racial inclusivity and pay equity to create a holistic evaluation of hospital social responsibility.

What's new on the Lown Index this year?

For 2026, we’ve made the following changes:

• The rankings consist of 2,718 Acute Care Hospitals and 900 Critical Access Hospitals. We identified the hospital type designation based on CMS Care Compare as of February 2026.
• 16 fewer hospitals are included in the LIHI rankings compared to last year; a total of 3,618 hospitals in the full dataset. One of the main reasons fewer hospitals are included this year is hospital closures. 
• For patient satisfaction, two items were dropped from CMS’s patient survey: Staff responsiveness and a patient’s understanding of their care when they left the hospital. These are no longer included in our metric.
• For unplanned hospital visits post outpatient surgery, we now exclude same day inpatient visits without an indication of care complications from the denominator, following an update in the CMS methods.
• For overuse, we only include hospitals in the measure if they have claimed at least 11 of the related services (for any patient). Previously, this requirement was lower.
• For cost efficiency, we now follow the CMS methods for calculating standardized allowed payments to account for geographic and other policy payment adjustments. We also now risk-adjust the total 30 or 90 day episode payment, instead of the payment per survival day. 

Read our methodology paper for the full list of changes.

How are the stars and grades calculated?

For each detail (e.g. racial inclusivity, financial assistance), hospitals receive between 1-5 stars and a ranking. The star ratings of 1-5 are based on hospitals’ relative performance. Raw scores are divided into 5 regions based on either quantiles from a standard normal distribution or equal split of the range of values. In this way, many hospitals may receive the same star rating if they perform similarly on a metric. 

The respective detail scores are weighted and combined to create grades and rankings for each component (e.g., inclusivity, community benefit). Each hospital gets a grade: A (highest) to D (lowest) based on their relative performance compared to other hospitals. 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 equity (40% weight), value (30%), and outcomes (30%).

Why did my hospital not receive a composite grade?

Some hospitals did not have enough patient stays to reliably calculate their cost-efficiency scores (118 hospitals) or did not have data available for two or more equity metrics (21 hospitals). These hospitals 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 U.S. states and Washington, DC
• Hospitals that are not included in Medicare fee-for-service or Medicare Advantage claims data (such as children’s hospitals)
• Federally-run hospitals (such as Veterans Health Administration or Indian Health Service hospitals)
• Specialty hospitals (such as orthopedic hospitals). We defined specialty hospitals as those with more than 45% admissions for orthopedic, more than 45% for cardiac, more than 80% surgical procedures, more than 80% elective surgeries (among hospitals with > 45% surgical procedures).
• Hospitals that were no longer in CMS Care Compare or we learned had closed as of February 2026.
• Hospitals with patient volume below 50 annual patient stays were also eliminated as well as hospitals that did not perform any surgery.

See the methodology paper for more details.