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Understanding the U.S. News & World Report Best Hospitals rankings

The methodology is complex and changes every year. These guides explain — in plain English, with the current sources cited — how the rankings actually work, what the scores and shields mean, and what a hospital can (and can’t) legitimately do to improve its standing.

In one paragraph

Each year, U.S. News & World Report evaluates U.S. hospitals using a mix of patient outcomes, other care-related measures (such as nurse staffing and the range of services offered), and a physician “expert opinion” survey. In the 2025–26 edition, U.S. News produced national rankings in 15 adult specialties and rated hospitals as “High Performing” across 22 procedures and conditions (the shield ratings). Hospitals that accumulate the most points across both are named to the Honor Roll.

Two different ways hospitals are recognized

It helps to separate the two tracks, because they work differently and are easy to confuse:

  • National specialty rankings. A numbered list of the top hospitals within a specialty (for example, the top 50 in Cardiology, Heart & Vascular Surgery). In 2025–26 there were 15 adult specialties. Twelve are data-driven — built largely from measured outcomes plus other indicators and the reputation survey — and three (Ophthalmology, Psychiatry, Rheumatology) are based on the physician survey alone.
  • Procedures & Conditions “High Performing” ratings — the shields. A pass/threshold rating (not a numbered rank) showing whether a hospital handles a common procedure or condition well. In 2025–26 U.S. News rated 22 procedures and conditions (such as heart attack, hip replacement, and COPD), determined largely by patient outcomes.

What goes into a specialty score

Per U.S. News & World Report’s 2025–26 Best Hospitals methodology, each hospital in the data-driven specialty rankings receives a score from 0–100 built from several weighted components:

ComponentWhat it captures (examples)
Patient outcomesRisk-adjusted survival and the rate at which patients can return home rather than needing further institutional care. U.S. News has been increasing the weight on outcomes.
Other care-related indicatorsNurse staffing intensity, patient volume, the breadth of services and key technologies, patient experience, and related structural/process measures.
Expert opinion (reputation)The physician survey administered by Doximity. Weighted about 15% in most data-driven specialties, reduced to 12% in four specialties with strong public transparency metrics, and 30% in Rehabilitation.

The three reputation-only specialties are scored entirely from the expert-opinion survey, aggregated over the most recent three years.

The Honor Roll

The Honor Roll recognizes the highest-scoring hospitals overall. Importantly, for the third year running, U.S. News does not number the Honor Roll — it lists qualifying hospitals alphabetically. Hospitals earn points for ranking in specialties and for High Performing ratings; in 2025–26, hospitals reaching 311 points were named.

Where the data comes from

Most of the score is built from data hospitals don’t submit directly — chiefly federal sources — plus two surveys:

  • CMS Medicare claims (MEDPAR) — the basis for risk-adjusted outcomes such as survival.
  • The American Hospital Association (AHA) Annual Survey — structural data such as staffing and services (supplemented by data hospitals report to U.S. News).
  • HCAHPS — the standardized patient-experience survey.
  • The physician expert-opinion (reputation) survey, administered by Doximity.
Methodology details change every year. The facts on this page reflect U.S. News’s published 2025–26 Best Hospitals methodology and are updated when U.S. News releases a new edition (typically mid-year).

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Sources

  1. U.S. News & World Report, “FAQ: How and Why We Rank and Rate Hospitals.” health.usnews.com
  2. U.S. News & World Report, “America’s Best Hospitals: The 2025–2026 Honor Roll and Overview.” health.usnews.com

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Shield Tracker helps hospital teams prepare and manage their U.S. News Best Hospitals data-submission survey and track their own scores, gaps, and year-over-year trends in one place. See it on your service lines.

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Independence & trademarks. Shield Tracker is an independent software product. It is not affiliated with, endorsed by, or sponsored by U.S. News & World Report. “U.S. News & World Report,” “Best Hospitals,” and “Honor Roll” are trademarks of U.S. News & World Report L.P., used here descriptively for education and commentary. “Doximity” is a trademark of Doximity, Inc. Methodology facts reflect U.S. News’s published 2025–26 Best Hospitals methodology and are subject to change.