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Methodology for the Fortune/IBM Watson Health 100 Top Hospitals 2021

100 Top Hospitals

To conduct the Fortune/IBM Watson Health 100 Top Hospitals study, IBM Watson Health researchers evaluated 2,675 short-term, acute care, non-federal U.S. hospitals. All research was based on the following public data sets: Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR) data, and core measures and patient satisfaction data from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website. Hospitals do not apply for awards, and winners do not pay to market this honor. For more information, visit http://www.100tophospitals.com/.

Fortune/IBM Watson Health 100 Top Hospitals 2020: Teaching Hospitals

Fortune/IBM Watson Health 100 Top Hospitals 2020: Community Hospitals

Class definition
Each hospital is defined within a class based on their bed size and teaching status.
Major Teaching - 208 Hospitals
Teaching - 605 Hospitals
Large Community - 254 Hospitals
Medium Community - 774 Hospitals
Small Community - 834 Hospitals

Final rank
Final rank is determined based on performance for all individual measures. Hospitals are ranked within their Class definition group.

New community health measure for 2021

For the 2021 100 Top Hospitals Study, we focused on the three components proposed by the Bloomberg American Health Initiative and the Center for Health Equity at the Johns Hopkins Bloomberg School of Public Health that would be derived from a hospital survey. The survey focuses on the role that a hospital can play including: (1) acting as a healthcare provider to provide services critical for community health and offering critical preventive services; (2) acting as a partner and teaming up with local organizations to implement critical programs; and (3) acting as an anchor institution and supporting local economic and social progress.

The community health measure is measured as a percentage. 100% is the highest score possible. Submitting a survey and sharing your data is 25% (data transparency). Each of the other components of the survey – hospital as a provider, hospital as a partner, and hospital as an anchor institution is worth an additional 25%. In order to receive the full 25% for each component, hospitals needed to attest to at least half of the best practice standards.

Hospital measure domains          

Clinical outcomes
There are five clinical measures used in the scorecard. Measures include (1) risk-adjusted IP mortality, (2) risk-adjusted complications, (3) healthcare associated infections*, (4) 30-day mortality and (5) 30-day readmissions. *Healthcare associated infections are excluded for the Small Community Hospitals peer group.

Operational efficiency
There are four operational efficiency measures used in the scorecard: (1) emergency department thoughput, (2) severity adjusted length of stay, (3) Medicare spending per beneficiary and (4) adjusted inpatient expense per discharge.

Patient experience
The patient experience measure reflects the overall patient rating from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey tool.

Financial health
The financial health measure used in the scorecard is adjusted operating profit margin.

Stars key:

  • 5 stars (★★★★★) = Hospital performing at top quintile (>80-100%) within their peer group
  • 4 stars (★★★★) = Hospital performing within second quintile (>60-80%) within their peer group
  • 3 stars (★★★) = Hospital performing within third quintile (>40-60%) within their peer group
  • 2 stars (★★) = Hospital performing within fourth quintile (>20-40%) within their peer group
  • 1 star (★) = Hospital performing in the bottom quintile (0-20%) within their peer group

Community health survey performance
The community health survey performance is based on the three survey components recommended by the Bloomberg American Health Initiative and the Center for Health Equity at the Johns Hopkins Bloomberg School of Public Health. The performance is measured as a percentage.

15 Top Health Systems

To conduct the IBM Watson Health 15 Top Health Systems study, IBM Watson Health researchers evaluated 324 health systems and 2,522 hospitals that are members of health systems. All research was based on the following public data sets: Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR) data, and core measures and patient satisfaction data from the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website. Health Systems and Hospitals do not apply for awards, and winners do not pay to market this honor. For more information, visit http://www.100tophospitals.com/

Fortune/IBM Watson Health 100 Top Hospitals 2021: Health Systems

Class definition
Each health system is defined within a class based on their total operating expense, number of U.S states in which they have member hospitals and the number of member hospitals:
Large Health Systems - 129 Health Systems
Medium Health Systems - 92 Health Systems
Small Health Systems - 103 Health Systems

Final rank
Final rank is determined based on performance for all individual measures. Hospitals are ranked within their peer group.

Hospital measure domains

Clinical outcomes
There are five clinical measures used in the scorecard. Measures include (1) risk-adjusted IP mortality, (2) risk-adjusted complications, (3) healthcare associated infections*, (4) 30-day mortality and (5) 30-day readmissions. *Healthcare associated infections are excluded for the Small Community Hospitals peer group.

Operational efficiency
There are three operational efficiency measures used in the scorecard: (1) emergency department thoughput, (2) severity adjusted length of stay, and (3) Medicare spending per beneficiary.

Patient experience
The patient experience measure reflects the overall patient rating from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey tool.

Stars key:

  • 5 stars (★★★★★) = Hospital performing at top quintile (>80-100%) within their peer group
  • 4 stars (★★★★) = Hospital performing within second quintile (>60-80%) within their peer group
  • 3 stars (★★★) = Hospital performing within third quintile (>40-60%) within their peer group
  • 2 stars (★★) = Hospital performing within fourth quintile (>20-40%) within their peer group
  • 1 star (★) = Hospital performing in the bottom quintile (0-20%) within their peer group

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