When CEO bonuses are tied to US News rankings

Here’s a quiz.  Can you guess who posted the following messages on Twitter?

Any idea how many hospital execs’ bonuses are tied to their institution’s U.S. News rankings? When execs confide this arrangement, they expect me to be impressed or flattered. Are you kidding? I’m deeply disturbed. In my view it’s a symptom the board has abdicated its responsibility to measure, monitor & incentivize quality improvement.

You might be surprised to learn that it was Ben Harder, @benharder, chief of health analysis at US News and World Report, the magazine that publishes “data, rankings & tools to help consumers choose hospitals, doctors, health plans & more.”

Probably more than anyone in the country, Ben understands the inherent limitations in any such rankings. More important, he understands that the rankings are designed to advise patients with complex medical conditions.  They are not an indication about the general level of quality of care or safety in an institution.

He certainly knows that hospitals use the rankings in their marketing materials, but he understands that what makes marketing effective is different from what makes it possible for a hospital to deliver the highest level of care and to engage in ongoing clinical process improvement.

Bravo to Ben for putting this out there so clearly. I’m hoping board members take note.