U.S. News revamps Best Hospitals formula to prioritize patient outcomes and outpatient performance

U.S. News rewrote key parts of its Best Hospitals formula for the 2026-2027 rankings, moving more weight toward patient outcomes, outpatient performance and local recognition, according to methodology documents and an Aug. 5 interview with senior health data analyst Chelsey Wen. The changes were published with the rankings on Aug. 4 and affected how hospitals were scored across adult specialties and regional lists. U.S. News said it ranked nearly 4,500 hospitals this year, with 16% receiving a “Best” designation and about 500 earning “Best Regional Hospital” status. ### Why did U.S. News change the formula this year? U.S. News said on May 20 that the 2026 edition would reflect “significant refinements” to keep pace with changes in care delivery, data availability and measurement science. The publication said risk-adjusted outcome measures would play a larger role than before in adult rankings and ratings. (health.usnews.com) Chelsey Wen said in the Aug. 5 Q&A that the methodology evolved “to reflect shifts from inpatient to outpatient and more local specialized care.” U.S. News also said this year’s evaluation gave more weight to measures such as mortality rates and preventable complications, while in some specialties reducing the role of expert assessment and patient volume. (health.usnews.com) ### Which specialty saw the biggest redesign? Cardiology, Heart & Vascular Surgery had the largest overhaul. U.S. News said outcome measures in that specialty rose to 80% of the score from 45%, and expert opinion, patient volume and most structural measures were removed. The redesign uses 41 outcome measures and two patient-experience measures to drive most of the score. (health.usnews.com) Wen said the result was less dramatic than the formula change might suggest. “The rankings results are largely similar to last year,” she said, even after the overhaul. But she added that the reduced emphasis on volume and increased emphasis on outcomes allowed more small to mid-volume hospitals to clear the threshold for high-performing status. (health.usnews.com) ### How did outpatient care and regional performance enter the rankings? U.S. News said the 2026 methodology added new regional specialty rankings in Cancer, Cardiology, Heart & Vascular Surgery, Orthopedics and Rehabilitation. In those categories, the top 50 hospitals are still ranked nationally, while the top 100 receive state and major-metro regional rankings in most of those specialties. U.S. News said the change was meant to recognize service-line hospitals and give patients more local options. (health.usnews.com) The methodology report also points readers to separate procedures-and-conditions ratings designed for lower-acuity care, including areas such as heart failure, hip replacement and lung cancer surgery. U.S. News said those ratings address patients whose needs may not require the most complex specialty centers. (health.usnews.com) ### Did the new formula change who shows up as a leader? HealthExec reported on Aug. 4 that the revised package still concentrated recognition among large academic systems and a handful of cities. Mayo Clinic appeared three times on the 20-hospital Honor Roll, for Rochester, Phoenix and Jacksonville, while New York City had three institutions on the list and California had five. (health.usnews.com) Wen said one notable shift was farther down the rankings. The number of hospitals with fewer than 200 beds in the Best Regional Hospitals group doubled from last year, she said, a sign that smaller hospitals benefited from the heavier weighting of outcomes over scale. ### What does U.S. News say patients should do with the rankings? (healthexec.com) U.S. News said the rankings are intended as a starting point for patients, not a final answer. Its FAQ says patients may in some cases be better served by a closer or in-network hospital rated “As Expected” or “High Performing,” depending on diagnosis, insurance and physician guidance. (health.usnews.com) The Aug. 4 release package also expanded the regional navigation around the rankings, including state, metro-area and community-access lists. U.S. News said those tools are meant to help patients compare local hospitals rather than focus only on the national Honor Roll. (health.usnews.com) U.S. News published the full 2026-2027 methodology reports on Aug. 4, and those documents now govern the specialty rankings, procedures-and-conditions ratings, regional hospital lists and community-access measures for the current cycle. (health.usnews.com) (healthexec.com)