Top-ranked hospitals still underperform in social responsibility

The Lown Institute is out with its updated list of the nation's most socially responsible hospitals. Just as in years past, many institutions that rank high on other quality ratings fell short of health equity metrics.

Indeed, only two of the hospitals on the U.S. News and World Report Best Hospitals Honor Roll earned an "A" grade from the Massachusetts-based think tank. Meanwhile, only one private equity-backed hospital received an "A" grade for social responsibility.

The Lown Institute's social responsibility ratings come out annually and assess hospitals on 50 different quality metrics, including health equity, value of care and patient outcomes. The 2024 ratings included more than 2,700 acute care hospitals. Of those hospitals, 154 earned "A" grades on equity, value and outcomes, which landed them on the Lown Index Honor Roll.

The Lown Institute focuses on social responsibility and other metrics related to healthcare access and equity to outline how different healthcare organizations serve traditionally marginalized populations, according to Vikas Saini, MD, president of the Lown Institute.

"Great care is only great if everyone can access it," Saini said in a statement. "Socially responsible hospitals are trusted to provide high-quality care to all, and their success directly improves the health and economic stability of their communities."

For 2024, the ten most socially responsible acute care hospitals in the U.S. are:

1. Duke Regional Hospital (Durham, N.C.).
2. Baylor Scott & White Medical Center -- Pflugerville (Pflugerville, Texas).
3. UCHealth Greeley Hospital (Greeley, Colo.).
4. Adventist Health Ukiah Valley (Ukiah, Calif.).
5. UNM Sandoval Regional Medical Center (Rio Rancho, N.M.).
6. Suburban Community Hospital (Norristown, Pa.).
7. Cedar City Hospital (Cedar City, Utah).
8. Methodist Medical Center (Oak Ridge, Tenn.).
9. St. Luke's Hospital -- Upper Bucks Campus (Quakertown, Pa.).
10. Sonoma Valley Health Care District (Sonoma, Calif.).

There's not a lot of overlap between these hospitals and the ones that top other quality ranking lists, Saini pointed out.

"Our rankings show there is considerable room for improvement in social responsibility, even among well-known and typically high-performing hospitals," he said.

Specifically, many of the U.S. News hospital honorees were missing from the Lown Institute's social responsibility rankings. This indicates that, despite providing quality healthcare, those hospitals do not deliver on health equity, the Lown Institute suggested.

Three U.S. News and World Report Best Hospitals honorees did receive Lown Institute honor roll status, including Mount Sinai Hospital, Temple University Hospital and MetroHealth, although they did not all receive "A" marks for the social responsibility metric. This is an improvement from last year when none of the U.S. News Best Hospitals received the Lown Institute's honor roll designation.

What's more, the Lown Institute reported lower performance in equity among hospitals backed by private equity.

Only one hospital system currently or recently owned by a private equity firm received an "A" grade in social responsibility. Meanwhile, for-profit hospitals, which comprise 18% of all acute care hospitals, accounted for around a third (36%) of "D" grades.

Even still, the 2024 social responsibility rankings show a marked increase in health equity from last year.

The Lown Institute said in its 2023 report that 54 hospitals made it to the top of their honor roll list; this year, that number was 154. Duke Regional Hospital sat at the top of the social responsibility rankings last year and remains there in 2024. Overall, 55 hospitals have received "A" grades for social responsibility for five years in a row.

Sara Heath has been covering news related to patient engagement and health equity since 2015.