How Boston-area hospitals stack up on social responsibility rankings

A unique new ranking system based on “social responsibility” metrics has placed several Boston-area hospitals far below top performers in measures like pay and racial equity.

The Lown Institute Hospitals Index, first published in 2020 by the Newton-based think tank, uses 53 metrics to rank hospitals based on health equity, value of care, and patient outcomes. Measurements used include rates of unnecessary stent placement procedures, racial inclusivity, and fair share spending. 

According to Lown’s website, none of the 2022-2023 U.S. News Honor Roll hospitals, which are determined by performance in hospitals’ specialties and procedures, received an “A” grade from the Institute in equity, but most did well on value and outcomes.

“There’s definitely a lot of examples where you say, ‘Oh wow, this is supposed to be one of the best hospitals in the country,’” said Aaron Toleos, vice president of communications for the Lown Institute. “And yet on this [ranking], they don’t do very well.”

Toleos said that most hospitals in the Boston area generally do well on the rankings, but lag behind on pay equity. According to the Lown Institute report, the CEO of Brigham and Women’s Hospital made $3,816,769 in 2020 — significantly above the national average nonprofit hospital CEO pay of $700,000.

Massachusetts General Hospital, for one, is nationally ranked 13th for adult specialties by U.S. News and is included in the publication’s “Best Hospitals Honor Roll.” But while the Lown rankings give it an A for value, they gave the hospital a C for equity and a B for outcomes.

Mass General was also ranked first in the state for coronary stent overuse, a procedure identified by the Lown Institute as being “low-value” and unnecessary in certain cases. 

Boston Medical Center ranked first in the country for racial inclusivity, which combines assessments of community benefit spending, pay equity, and inclusivity. The hospital also made the top of the list for the largest fair share surpluses, or the proportion of spending on charity care and community investment compared to the value of their tax exemption. 

Brigham and Women’s ranked 428th for racial inclusivity, and Massachusetts General Hospital came in at No. 607. 

In the equity category, Falmouth Hospital ranked the highest on the equity ranking compared to other Massachusetts hospitals, and Beth Israel Deaconess Medical Center was ranked the highest of Massachusetts hospitals for value of care. 

The Lown Institute says it aims to help hospitals determine and set goals regarding the measured factors. 

“Pretty much every hospital talks about how it wants to be there for its community, to be a great community partner and service the community,” Toleos said. “A lot of hospitals put a lot of emphasis on equity, but what we’ve found is that there’s a lack of metrics available to actually measure how they’re doing.”

According to Toleos, the Institute uses the most current data available and bases its assessments on the most recent academic literature. 

“This data is useful to any hospital that is serious about improving its social responsibility,” Toleos said. “It can be used by hospitals to track their progress and set goals for doing better. It can be used by community members who want to hold their hospital accountable. Patients may be choosing where to go for a certain procedure may take the overuse data into account.”