Methodology

For the list, Healthgrades looked at clinical outcomes in the following procedure areas:

• Total knee replacement
• Total hip replacement
• Rotator cuff surgery
• Back and neck surgeries (without spinal fusion)

To measure outpatient performance, Healthgrades analyzed Medicare outpatient and inpatient data from CMS' Standard Analytics Files from 2020 through 2022. Patient outcomes data for the four procedures were then analyzed for nearly every hospital in the United States.

Healthgrades then assigned a star rating to each hospital as an evaluation of the hospital's actual performance compared to the predicted performance for that hospital based on a specific risk-adjustment model applied to the facility.

According to Healthgrades, hospitals that received:

• One star performed "worse than expected," meaning their "actual performance was worse than predicted and the difference was statistically significant"
• Three stars performed "as expected," meaning their "actual performance was not statistically significantly different from what was predicted"
• Five stars performed "better than expected," meaning their "actual performance was better than predicted and the difference was statistically significant"

To be eligible, a hospital must meet at least one performance requirement in three out of the four procedures listed.

The Outpatient Orthopedic Surgery and Joint Replacement Excellence Awards

Alongside its star ratings, Healthgrades also issued two specific awards:

• The Outpatient Joint Replacement Excellence Award, which was awarded to 152 hospitals representing the top 10% in the United States
• The Outpatient Orthopedic Surgery Excellence Award, which was awarded to 134 hospitals representing the top 10% in the United States

According to Healthgrades, patients treated at a hospital that received a 2024 Outpatient Joint Replacement Specialty Excellence Award have roughly a 38% lower risk of experiencing a complication than if they were treated at a non-recipient hospital.

Similarly, Healthgrades noted that patients treated at a hospital that received a 2024 Outpatient Orthopedic Surgery Specialty Excellence Award have roughly a 40% lower risk of experiencing a complication than if they were treated at a non-recipient hospital.

According to Healthgrades, the Hospital for Special Surgery (HSS) was the only hospital in the United States to achieve a five-star rating in all four outpatient surgery cohorts.

"As outpatient surgery options become more available, it is very important that consumers have trustworthy guidance on the facts and implications of quality differences," said Bryan Kelly, HSS president, CEO, and surgeon-in-chief emeritus. "HSS appreciates this unique recognition by Healthgrades, and its potential to help consumers make better choices about their care and encourage all providers to prioritize quality improvement," he added.

Healthgrades noted that if all hospitals had performed similarly to those receiving five stars, more than 20,000 complications could have been avoided.

"As the trend towards outpatient orthopedic care grows, it is increasingly vital that consumers are equipped with the necessary information to make fully-informed decisions about where to receive healthcare," said Brad Bowman, CMO and head of data science at Healthgrades. "As pioneers in health transparency, Healthgrades is proud to be at the forefront of publishing outcomes-based outpatient ratings. We are particularly excited to expand our analysis this year, giving consumers even more visibility into where to find the highest quality outpatient orthopedic care."

Click here for the full list of award recipients.

(Healthgrades press release, 2/13; Healthgrades Top Hospitals for Outpatient Orthopedic Surgery methodology, 2/13)

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