Here we go again. It’s a “six-peat” for Mayo Clinic.
For the sixth consecutive year, Mayo Clinic has been named the top hospital in U.S. News & World Report magazine’s annual ranking of the nation's top 20 Best Hospitals.
As in the wake of past rankings, Mayo Clinic executives cite the sprawling healthcare enterprise’s almost 73,000 employees for providing award-winning care.
“... We are truly grateful to our extraordinary staff for always putting our patients’ needs first in the exceptional care that they provide,” stated Mayo Clinic CEO Gianrico Farrugia in the announcement of the rankings.
Following Mayo Clinic are Cleveland Clinic and UCLA Medical Center, Los Angeles, at number two and three. UCLA took the third spot from Johns Hopkins Hospital. Johns Hopkins was ranked fourth with Massachusetts General rounding out the top five.
Mayo Clinic in Arizona was ranked in the 15th, up from 16 on last year’s list.
The magazine added new separate rankings for 15 medical specialties to this year’s report. Out of the 4,750 hospitals that were evaluated, 175 were nationally ranked in at least one specialty.
Mayo Clinic was No. 1 in diabetes and endocrinology, gastroenterology and GI surgery, gynecology, nephrology, pulmonology and lung surgery, and urology.
It was second in cardiology and heart surgery as well as orthopedics. It was third in cancer treatment and rheumatology.
The data used by U.S. News & World to calculate all of the 2021-2021 rankings came from “a period predating the COVID-19 pandemic and were not affected by the pandemic’s impact on hospitals.”
While being repeatedly ranked No. 1 on this list feels like a “Groundhog Day” time loop, Mayo Clinic’s interim Chief Value Officer Dr. Andrew Limper said being named the top hospital is still important for a variety of reasons.
“First of all, of course, it's an honor and a recognition to be ranked the No. 1 hospital in the United States by U.S. News. The importance to patients is that it provides a measure of the places that they can go for serious and complex care, when they have a real medical problem that they need to have attended to,” he said. “It's a measure of the quality of the institution. I think referring doctors who have a patient with a complex problem also use those rankings to help to select where to send him or her for their advanced health care.”
This year’s rankings did include new criteria about health equity, including whether the patients each hospital has treated reflect the racial and ethnic diversity of the surrounding community.
“At roughly four out of five hospitals, we found that the community’s minority residents were under-represented among patients receiving services such as joint replacement, cancer surgery and common heart procedures,” said U.S. News Managing Editor Ben Harder. “Against this backdrop, however, we found important exceptions – hospitals that provide care to a disproportionate share of their community’s minority residents. These metrics are just a beginning; we aim to expand on our measurement of health equity in the future.”
That’s an aspect that Mayo Clinic has been recently spotlighting as a goal.
“We're working within the community as well as within our regions to provide equitable care across the board. We have established offices to look at how we deliver care, but also how we interface with the community. And how to have a very fair and inclusive workplace,” Limper said. “We want to be an inviting culture for everyone who gets care here and works here.”
Also new to the ranking this year were criteria about the management of seven conditions and procedures including heart attack, stroke, pneumonia, diabetes, kidney failure, hip fracture and spinal fusion.
This ranking, while considered the best by many, is not the only top hospital list. Newsweek magazine published an annual “World’s Best Hospitals” ranking. For 2020, it placed Mayo Clinic at No. 1, followed by Cleveland Clinic and Massachusetts General Hospital.
The Leapfrog Top Hospital list does not rank medical institutions, but compiles a list focusing on patient safety based on systems in place to prevent medication errors, higher quality on maternity care, lower infection rates and other safety factors. Neither Mayo Clinic nor any other Minnesota hospitals made that list in 2020.
The Lown Institute, a nonpartisan health care think tank, also creates a best hospital list including factors such as civic leadership and the value of care to its scoring system to judge how well a hospital fulfills its mission to provide care for a community. The addition of those factors knocked Mayo Clinic out of its usual top spot to place at 965th out of 3,282 U.S. hospitals in 2020.
The annual release of the U.S. News ranking marks the beginning of a new marketing campaign for the top hospitals, who spend millions on ads, banners, lapel pins and commercials to advertise their spots on the prestigious list. The magazine also sells a “badge” denoting the ranking that hospitals can use on their web sites and other promotional materials.
U.S. News & World’s website dedicated to the list provides links for readers to directly request treatment at the top hospitals. The magazine also publishes a Best Hospitals guidebook, full of advertisements from the hospitals.
U.S. News & World does not release to the general public how much those ads, badges, lapel pins and back issues cost for the hospitals, but it’s estimated that money generated by the annual list from the hospitals is significant.
Prior to the 2016-17 Best Hospitals ranking, Mayo Clinic typically was in the top three, and claimed No. 1 in 2014. However, the magazine began to calculate the scores different, after complaints from Mayo Clinic.
Then-CEO Dr. John Noseworthy recounted a meeting he had with the publisher of U.S News & World Report during a speech at the annual Rochester Area Chamber of Commerce meeting in 2017. He pointed out to the magazine’s leaders what he saw as a flaw in how the rankings were calculated.
At the end of an hour-long meeting, he showed them a color graph listing Mayo Clinic as receiving the most rankings in some specialty areas.
"I asked them, could they help me explain to our trustees and staff why Mayo Clinic wasn’t No. 1 that year? They were literally silent for a minute and they asked to have the chart," Noseworthy said.
He explained that his critique spurred the magazine to take into account treating "seriously complex patients” when calculating the annual rankings.
"The Mayo Clinic model is really engineered for these patients that come here from everywhere to get the puzzle solved, get complex care given and to get hope when hope isn’t apparent," Noseworthy said. "The difference between Mayo Clinic and other terrific medical centers is becoming more apparent."
Now that Mayo Clinic has consistently been ranked at No. 1, what does the clinic need to do to fend off competitors looking to unseat them?
“That's an interesting question. Because you know, at the end of the day, I don't think we focus on the rankings as much as what's right for the patient. The Doctors Mayo would always say, if you focus on the needs of the patient, everything else falls in line. And it really does, “ said Limper. “We work on that team care and we provide new treatments for folks. And we continue to try to be ever safer and more efficient and provide a great experience. And when we do that, you know, hopefully the rankings work out.”
“It is great to get the rankings," he said. "Of course we're very honored, but we do what we do to provide the best care for the patient."