- Findings show Memorial Hermann Texas Medical Center is ninth-best in nation -
A new ranking of U.S. hospitals shows that those with good clinical outcomes tend to score poorly in addressing inequities that affect the health of their communities.
With that in mind, the rankings show that Memorial Hermann Texas Medical Center in Houston is in the Top 10 in the nation.
The Lown Institute, a Brookline, Mass.-based nonpartisan think tank used never-before-considered measures for its Lown Institute Hospitals Indexto help hospitals better serve and support their communities. The index shows how hospitals compare on 42 performance indicators. The measures fall under three categories: civic leadership, which assesses a commitment to equity, inclusion and community health; value of care, which measures use of unnecessary services; and
patient outcomes, which evaluates patient outcomes, safety and satisfaction.
“At a time when communities are relying on them like never before, hospitals must rethink what it means to be great,” said Dr. Vikas Saini, M.D., president of the Lown Institute. “COVID-19 highlights how hospitals are essential community partners for anyone in need. To be great, however, a hospital cannot only provide care that’s high in quality. It must also deliver value and advance equality. Our index is designed to help them do just that.”
Based on the index’s measures, the Houston area’s Top 10 hospitals are: Memorial Hermann Texas Medical Center-Houston; Harris Health System-Houston; Memorial Hermann Northeast Hospital-Humble; Memorial Hermann Hospital System-Houston; Brazosport Regional Health System-Lake Jackson; The Woman’s Hospital of Texas-Houston;
Memorial Hermann Katy Hospital-Katy; Houston Methodist San Jacinto Hospital-Baytown; Memorial Hermann Sugar Land Hospital-Sugar Land; and Memorial Hermann Memorial City Medical Center-Houston.
“There are some very fine hospitals that feel forced to focus on profitable elective procedures to stay in business,” said Saini. “This can lead to business decisions that make them look good on outcomes like mortality, but at the expense of equity. The data show that gaps between a hospital’s clinical results and its performance in the community are sometimes very wide, which can contribute to disparities in care and put certain communities at risk.”
The Lown Index results are available at LownHospitalsIndex.orgwhere people can compare hospitals based on location, hospital type and metric. It is also the data source for the Washington Monthly’s “Best Hospitals for America” issue, released simultaneously.
Under “civic leadership,” the index measures often-overlooked indicators that are essential to understanding how hospitals behave in their communities, both where they succeed and where improvement is needed. It’s different from other hospital rankings because it is the first to address how much hospitals spend on meaningful community benefits as well as the proportion of low-income patients they serve. Nonprofit hospitals get billions of dollars in tax breaks every year but vary widely in how much they actually give in community benefits.
The index is the first hospital ranking to measure inclusivity or the degree to which a hospital is caring for patients of color and of lower income or education. It is also the first to measure the ratio of executive compensation to that of employees without advanced degrees. Many of the hospitals that perform best in civic leadership are not names most have heard before.
The Harris Health System is the top in the nation in this category.
To determine hospitals’ value of care, the Lown Institute assessed hospitals based on estimates of their rates of overuse, including hysterectomy for benign disease, head imaging for simple headaches, and 11 other procedures and tests. The Lown Institute is the first hospital ranking to use such a metric. The research found that for-profit hospitals and those in certain states, particularly in the South, were more likely to overuse low-value services measured.
To determine hospitals’ quality of care, the Lown Institute used an algorithm called the Risk Stratification Index (RSI) that has been validated on multiple national, state-based and hospital-based data sets using billions of insurance claims. RSI has been shown to predict outcomes such as mortality with greater discriminatory accuracy compared with other publicly available risk adjustment tools.
In the Houston region, the best hospital on quality among the Top 10 is the Memorial Hermann-Memorial City Medical Center.
“No other hospital ranking provides a 360-degree view of hospital performance,” said Shannon Brownlee, senior vice president at the Lown Institute. “Many of the best-known hospitals score highly on patient outcomes but poorly on civic leadership and value of care. Our data show that it’s possible to do well in all three categories because some hospitals are doing it. That means all the people in their communities are being served effectively and fairly.”
The index uses data from a wide variety of sources, including the 100% Medicare claims data sets (MEDPAR and outpatient); IRS pulled from Community Benefit Insight database; Healthcare Cost Report Information System administered by the Centers for Medicare and Medicaid Services; SEC filings; public records; Bureau of Labor Statistics; and other databases.