San Francisco City Attorney David Chiu has successfully prompted US News & World Report to disclose payments made by hospitals for their rankings in the publication’s annual “Best Hospitals” list. This development follows an investigation led by Chiu’s office, which raised concerns about the transparency of the ranking methodology used by the publication.
Investigation Reveals Payment Violations
Chiu’s office began its investigation in 2023, uncovering that at least one hospital paid $42,000 for a “Best Hospitals” badge, a fact that was not disclosed as required by the Federal Trade Commission Act. According to a press release from Chiu’s office, US News also offers various paid options for enhanced visibility, including “Featured Hospital” placements and advertising opportunities.
When US News did not respond to a letter from Chiu in 2023, he issued two subpoenas in January 2024, requesting documents and information from the publication. In response, US News filed a lawsuit, claiming that the investigation infringed on its First Amendment rights. By May 2024, the lawsuit was dismissed, and the parties reached an agreement in April 2024, which included the requirement for US News to provide disclaimers on any pages that generate revenue from hospital rankings.
“Consumers use these hospital rankings to make consequential health care decisions,” Chiu stated. “My office is committed to defending consumers’ best interests, so I’m glad we were able to reach a settlement that ensures greater transparency in US News’s financial disclosures.”
Calls for Methodology Reform
In addition to advocating for financial transparency, Chiu criticized the existing ranking methodology in an op-ed published in US News on August 29, 2023. He expressed concerns about the limitations of the data used, which primarily originates from Medicare, rendering the rankings less applicable to younger populations. Chiu emphasized that including data from private insurers and Medicaid would provide a more comprehensive view of hospital quality.
Chiu also pointed out that current rankings heavily weight certain conditions, such as allocating at least 19 points for cystic fibrosis treatment, while only awarding 1 point for sickle cell disease treatment. This disparity highlights potential biases in the ranking process that could lead hospitals to prioritize certain specialties over others.
“It is not enough to provide stellar care to a select group of patients and not others,” Chiu remarked. He argued that the existing methodology primarily benefits prestigious hospitals, allowing them to attract more funding while community hospitals struggle to remain viable.
Chiu concluded his op-ed by encouraging the public to recognize that the best hospital for an individual is often the one in their local community. He advocated for a more nuanced approach to hospital rankings that focuses on key quality metrics, rather than a straightforward competitive ranking system.
This investigation and subsequent settlement reflect a growing demand for transparency and accountability in healthcare rankings, emphasizing the need for methodologies that genuinely represent the quality of care provided to all patients.
