U.S. News & World Report on Tuesday released its 31st annual Best Hospital rankings, with Mayo Clinic topping the publication's "Honor Roll" for the fifth year in a row.

Cheat sheet: How US News calculates its 'Best Hospital' rankings

For the 2020-2021 list, U.S. News drew from the 4,554 hospitals and health care facilities included in the American Hospital Association's Annual Survey of Hospitals.

U.S. News evaluated facilities across 16 specialties. On the latest list, 134 hospitals ranked in at least one specialty.

The publication also named 20 facilities to its "Honor Roll" for achieving strong performance in multiple specialties.

How hospitals were ranked

To qualify to be ranked as one of the top specialty hospitals, hospitals must meet one of the following criteria:

• Be a teaching hospital;
• Be affiliated with a medical school;
• Have at least 200 beds; or
• Have at least 100 beds and offer four or more types of medical technology considered by U.S. News to be key to high-quality care, such as PET/CT scanners.

U.S. News ranked four of the 16 specialties—ophthalmology, psychiatry, rehabilitation, and rheumatology—based on a survey of experts.

For the other 12 specialties, U.S. News determined the rankings based largely on federal and industry data, although it also incorporated results from a reputational survey. The 12 data-driven specialties are:

• Cancer;
• Cardiology & heart surgery;
• Diabetes & endocrinology;
• Ear, nose, & throat;
• Gastroenterology & GI Surgery;
• Geriatrics;
• Gynecology;
• Nephrology;
• Neurology & neurosurgery;
• Orthopedics;
• Pulmonology & lung surgery; and
• Urology.

To achieve a rating in a specific specialty, hospitals had to meet a volume/discharge requirement that varied by specialty, or—if a hospital did not meet the volume/discharge requirement—hospitals had to have received nominations from at least 1% of the specialists responding to the reputational surveys over the past three years.

According to U.S. News, 1,889 hospitals were eligible to be considered for a rating among the 12 data-driven specialties. U.S. News then scored eligible facilities based on four factors (with the exception of cardiology & heart surgery and neurology & neurosurgery, which had slightly different methodologies):

• Outcomes, measured by risk-adjusted mortality (37.5%);
• Structure of hospital resources directly related to patient care (30%);
• Process of delivering patient care/expert opinion (27.5%); and
• Patient experience (5%).

Cardiology & heart surgery programs and neurology & neurosurgery programs were also judged on an additional fifth factor: Public transparency.

For cardiology & heart surgery programs, public transparency was measured by whether the programs publicly report quality metrics through American College of Cardiology and the Society of Thoracic Surgeons websites. Public transparency was weighted at 3% for these programs, while process/expert opinion was weighted at 24.5%.

U.S. News also added a transparency measure for neurology & neurosurgery programs for the first time for the 2020-2021 rankings. The transparency metric was weighted at 2%, while process/expert opinion was weighted at 25.5%. Public transparency was measured by whether the programs reported on certain stroke care metrics via the American Heart Association's Get With The Guidelines stroke quality improvement program.

Honor Roll

U.S. News recognized 20 facilities on an "Honor Roll." According to U.S. News, the facilities on the list demonstrated "exceptional treatment" in several areas. The honor roll awardees, ranked from one to 20, included:

1. Mayo Clinic (Rochester, Minnesota);
2. Cleveland Clinic (Cleveland);
3. Johns Hopkins Hospital (Baltimore);
4. New York-Presbyterian Hospital-Columbia and Cornell (New York);
5. UCLA Medical Center (Los Angeles);
6. Massachusetts General Hospital (Boston);
7. Cedars-Sinai Medical Center (San Francisco);
8. UCSF Medical Center (San Francisco);
9. NYU Langone Hospitals (New York);
10. Northwestern Memorial Hospital (Chicago);
11. University of Michigan Hospitals-Michigan Medicine (Ann Arbor, Michigan);
12. Brigham and Women's Hospital (Boston);
13. Stanford Health Care-Stanford Hospital (Palo Alto, California);
14. Mount Sinai Hospital (New York);
15. Hospitals of the University of Pennsylvania-Penn Presbyterian (Philadelphia);
16. Mayo Clinic-Phoenix (Phoenix);
17. Rush University Medical Center (Chicago);
18. Barnes-Jewish Hospital (St. Louis);
19. Keck Medical Center of USC (Los Angeles); and
20. Houston Methodist Hospital (Houston).

Hospital heroes

As part of this year's rankings, U.S. News also published a list called U.S. News Hospital Heroes, which includes more than 65 health care workers from across the United States who "have stepped up during [the country's coronavirus epidemic], often at great personal risk."

"The [epidemic] has altered, perhaps permanently, how patients get care and from whom they get it. Amid the disruption, we are steadfastly committed to providing the public with authoritative data for comparing hospital quality," Ben Harder, managing editor and chief of health analysis at U.S. News said. "No hospital's clinical team came through this unprecedented health crisis unscathed. Our Hospital Heroes series is a tribute to recognizing individuals at urban and rural hospitals in communities across the country who have gone above and beyond during this unparalleled time in history," Harder added (U.S. News release, 7/28; U.S. News, Honor Roll, 7/28; U.S. News methodology, 7/28).