Methodology

For the rankings, Lown excluded non-acute care hospitals, non-critical access hospitals, federal hospitals, hospitals outside the 50 states and Washington, D.C., and specialty hospitals with more than 45% admissions for orthopedic or cardiac procedures, or more than 80% for surgical procedures or elective surgeries.

Hospitals that were closed as of February 2024, those with volumes below 50 annual patient stays, and those that did not perform any surgery were also excluded, leaving 3,680 eligible hospitals, including 523 for-profits and 3,157 nonprofits.

This year, Lown created separate rankings for short-term acute care and critical access hospitals. Overall, there were 2,784 acute care hospitals and 896 critical access hospitals.

Eligible hospitals were given an overall letter grade based on their performance across three categories, as well as separate grades for their performance in each individual category. The categories were:

• Equity, which included the subcomponents of pay equity (how much a hospital's executives are paid compared with its frontline workers); community benefit; and inclusivity (described as "the degree to which a hospital's patient population reflects the demographics of its community area")
• Value, which included the subcomponents of "avoiding overuse" and cost efficiency
• Outcomes, which included the subcomponents of clinical outcomes, patient safety, and patient satisfaction

The Lown Institute assessed performance across these categories and subcomponents by pulling from sources such as the CMS Healthcare Cost Report Information System, IRS 990 forms, the U.S. Census Bureau's American Community Survey, Medicare inpatient, outpatient, and carrier claims data on CMS' Virtual Research Data Center, and more.

The top 20 U.S. hospitals

The top 20 most socially responsible acute care hospitals were:

1.       Duke Regional Hospital (Durham, NC)

2.       Baylor Scott & White Medical Center – Pflugerville (Pflugerville, TX)

3.       UCHealth Greeley* (Greeley, CO)

4.       Adventist Health Ukiah Valley* (Ukiah, CA)

5.       UNM Sandoval Regional Medical Center (Rio Rancho, NM)

6.       Suburban Community Hospital (Norristown, PA)

7.       Cedar City Hospital (Cedar City, UT)

8.       Methodist Medical Center* (Oak Ridge, TN)

9.       St. Luke's Hospital – Upper Bucks Campus* (Quakertown, PA)

10.   Sonoma Valley Health Care District (Sonoma, CA)

11.   Providence Newberg Medical Center* (Newberg, OR)

12.   Fort Loudoun Medical Center (Lenoir City, TN)

13.   Saint Alphonsus Medical Center – Ontario* (Ontario, OR)

14.   LDS Hospital (Salt Lake City, UT)

15.   St. Luke's Hospital – Easton Campus* (Easton, PA)

16.   CommonSpirit – St. Anthony Summit Hospital (Frisco, CO)

17.   Park City Hospital (Park City, UT)

18.   St. Luke's Hospital – Miners Campus* (Coaldale, PA)

19.   Stillwater Medical Center (Stillwater, OK)

20.   Southern California Hospital at Hollywood* (Hollywood, CA)

The top 20 most socially responsible critical access hospitals were:

1.       Sidney Health Center (Sidney, MT)

2.       St. Luke's Elmore Medical Center* (Mountain Home, ID)

3.       Whitman Hospital & Medical Center (Colfax, WA)

4.       Sanford Luverne Medical Center* (Luverne, MN)

5.       St. Charles Madras* (Madras, OR)

6.       Marshall Medical Center (Lewisburg, TN)

7.       Sanford Canton – Inwood Medical Center* (Canton, SD)

8.       UCHealth Pikes Peak Regional Hospital (Woodland Park, CO)

9.       Wayne County Hospital (Corydon, IA)

10.   United Hospital District (Blue Earth, MN)

11.   Mercy Hospital Kingfisher* (Kingfisher, OK)

12.   Skyline Hospital (White Salmon, WA)

13.   Pike County Memorial Hospital (Louisiana, MO)

14.   CentraCare – Melrose Hospital (Melrose, MN)

15.   Avera St. Anthony's Hospital* (O'Neill, NE)

16.   Western Wisconsin Health (Baldwin, WI)

17.   Edgerton Hospital & Health Services (Edgerton, WI)

18.   MercyOne Elkader Medical Center (Elkader, IA)

19.   Providence Mount Carmel Hospital* (Colville, WA)

20.   Chatham Hospital* (Siler City, NC)

(*Denotes an Advisory Board member)

Commentary

"Great care is only great if everyone can access it," said Vikas Saini, president of the Lown Institute. "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."

According to Lown, its Hospitals Index is unique since it includes equity metrics, like racial inclusivity and pay equity, as well as more traditional outcome measures.

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

However, the American Hospital Association (AHA) has criticized the rankings in the past. After the release of the 2021 rankings, AHA said the Lown Institute's index draws "sweeping and arbitrary conclusions" and uses "old and incomplete data."

Specifically, AHA took issue with some of the rankings' metrics only using Medicare data, which AHA said is not representative of the communities cared for by hospitals.

"Hospitals treat the patients who come through their doors regardless of their ability to pay, and those who do enter the hospital may or may not match with the demographics of the Medicare population," AHA said. "Yet Lown penalizes hospitals whose patient mix does not match the local Medicare population."

AHA also took issue with the rankings' use of mortality as the only clinical outcome to measure cost efficiency.

"These and other shortcomings may explain why researchers themselves acknowledge the index won't help patients actually choose between hospitals," AHA said. (Bean, Becker's Hospital Review, 6/25; Toleos, Lown Institute, 6/25; "The Lown Index Ranking for Social Responsibility" methodology, accessed 6/26; "America's Most Socially Responsible Hospitals" rankings, accessed 6/26)

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