Mansfield says the report is meant to be a tool for hospital leaders to make sense out of the various report cards. It is not meant as endorsement of any one. From letters grades to check marks, the variation among the reports can be confounding, so HANYS developed nine criteria for grading the report cards:
Leapfrog and U.S. News and World Report received only one star from HANYS because both organizations fully or partially met only a few of the criteria. The transparency of each organization's methodology was included as a criterion (one that Leapfrog passed, but U.S. News and World Report failed) because HANYS believes the results should be able to be replicated.
Most of the report cards were credited with using evidence-based measures to develop their individual rankings. HANYS's report, however, criticized the America's Best Hospitals Report, issued by Healthgrades, because it doesn't "provide scientific evidence" that shows the relationship between its 28 measures of complication and mortality and a hospital's quality. U.S. News and World Report's Best Hospitals List also received criticism for relying on "subjective perception".