Frequently Asked Questions

How do the component grades roll up into the composite grade?

The composite (overall) grade is calculated by weighing the hospital's raw scores for each component. Because we calculate the composites based on raw scores rather than their relative grades, a hospital's very high or very low score in one of the components will have a larger impact on the overall score. This means that hospitals with the same grades for each category could have different composite grades, if their raw scores are very different.

To use an analogy, if you’re running a race, you could finish one second behind the person in front of you or ten minutes behind them. Either way, you would get the same place in the race (second, third, etc.), but you would have very different finishing times. The composite score takes differences in times into account, rather than just how hospitals placed.

Why did my hospital not receive a composite grade?

Hospitals that did not have overuse data available (77 hospitals) were not given a composite score. These hospitals were still graded on the components for which data were available.

Why is my hospital missing from the Index?

Hospitals that are not included in Medicare fee-for-service data (such as children’s hospitals) or specialty hospitals (such as cancer hospitals) are not included in the Index. See methodology 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 2017 data and may not reflect current membership.

The Index does not reflect my hospital’s most recent data on some of these metrics. Why?

For each metric, we used the most recent data available across all hospitals. For example, we used Medicare data from 2015-2017 because it was the most recent data set available that made it possible to calculate 1-year mortality.

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

The Lown Index is the only ranking to include measures of hospital civic leadership and avoidance of unnecessary tests and treatments. We believe hospital performance should be measured not only based on patient outcomes, but also on how well hospitals fulfill their civic responsibility and avoid overuse.

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.

Understand the Rankings

The Lown Index rolls up scores from 42 detailed metrics, 7 components, and 3 categories to create an overall composite score.

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