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Hopkins reclaims 'top hospital' ranking

Rebounds after one year in second place in U.S. News ratings

By Timothy B. Wheeler, The Baltimore Sun

8:43 AM EDT, July 16, 2013

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Johns Hopkins Hospital is back on top — reclaiming bragging rights and a lucrative marketing chip as the nation's best hospital in the annual ranking released Tuesday by U.S. News and World Report.

A year after being knocked from its 21-year perch atop the news organization's hospital ratings, Hopkins rebounded by edging out last year's winner, Boston's Massachusetts General Hospital.

"We're very pleased about that, because we had quite a story going," said Ronald R. Peterson, president of Hopkins Hospital and Health System and executive vice president of Johns Hopkins Medicine. He said hospital executives hadn't consciously set out to regain top honors over the past year, noting that he never really understood how Hopkins had lost out to Mass. General in the first place.

"It's not absolutely clear to me that you can do anything just in a year's time," Peterson said, noting that U.S. News doesn't give advance notice of methodology changes. "So it's not exactly something you can necessarily plan for."

There were a few tweaks in how hospitals were ranked this year, but not enough to give an obvious advantage to any of those bunched atop U.S. News' "honor roll" of 18 premier health-care centers. Mayo Clinic in Rochester, Minn., ranked third, though both it and Mass. General lagged behind Hopkins by just a single point.

About one-third of the factors behind the rankings are based on a hospital's "reputation" among a selection of medical specialists, but the rest are derived from data about patient outcomes, safety and other issues.

"In the upper reaches of this stratosphere, it just isn't worth figuring out what happened," said Avery Comarow, health rankings editor. In an evaluation of nearly 5,000 medical centers nationwide, he said the honor-roll hospitals were distinguished by a "culture of performance" that resulted in multiple top-rated specialties. Whichever one comes out on top between the top two is "pretty much a tossup," he said.

He cautioned against reading too much into the hospital rankings, saying consumers should consult them as a first step but delve deeper into the type of treatment they need and even the individual care-givers.

"It's got lots of marquee value," he said, but "people don't go to a hospital because they're being treated for 16 different specialties."

Hopkins, for instance, was deemed to offer the best care in five specialties — ear, nose and throat, geriatrics, neurology and neurosurgery, rheumatology and urology — with 10 others nationally ranked. Hopkins missed getting a national ranking in only one of 16 specialties evaluated by U.S. News — rehabilitation.

"Our hospital's standings in the specialties ranked by U.S. News reflect the strong performance and historic leadership of our institution," said Paul B. Rothman, CEO of Johns Hopkins Medicine and dean of the medical faculty, in a statement.

The University of Maryland, by comparison, didn't make the U.S. News "honor roll," but it was nationally ranked in five specialties, and deemed "high-performing" in seven others. Last year, it earned national ranking for nine specialties.

"University of Maryland and Hopkins continue to show leadership in the national rankings and provide outstanding care to the citizens of Maryland," Mary Lynn Carver, spokeswoman for UM medical system and center, said in an email.

Peterson said he had wondered how Hopkins, with five top-ranked specialties, had lost out last year to Massachusetts General, which had none. But he quickly added: "The bottom line is we're just very pleased to be among the institutions that are rated so highly."

Marketing experts say the bottom line is why hospital executives pay so much attention to the rankings.

"There's evidence that awards steer patients to a hospital," said Chris Bevolo, president and founder of Interval, a health-care marketing firm in Minneapolis.

"Obviously, in many cases they don't choose the hospital, the doctor does," added Kenneth L. Bernhardt, professor of marketing at Georgia State University. "But in some cases they choose the doctor because they have access to that hospital."

Bevolo nevertheless said rankings can be a shaky basis for selling a hospital to the public. The ratings field has become crowded, he said, and top rankings come and go from year to year, making it challenging to maintain a consistent message.

Top rankings "should always be celebrated internally," he said, "but you really have to question the value of going out there and trying to convince people of how great you are. But again, if you've been No. 1 for 21 years, it's hard to dispute that."

U.S. News isn't above taking advantage of its own longstanding reputation for rating hospitals, now in its 24th year, by selling the right to use its "Best Hospitals" badge in promotional materials.

Hopkins has never paid for the U.S. News badge and doesn't intend to, said spokeswoman Kim Hoppe. But the East Baltimore institution does intend to take out an ad in The Baltimore Sun noting its return to national pre-eminence in the ratings.

"Does it make my life easier?" Peterson said of the ranking. "Maybe for a little bit."

But then, he added, the hospital trustees will soon be pressing him to "look forward to the next year or the next problem."

tim.wheeler@baltsun.com