Highlight
- Johns Hopkins Hospital is ranked as the best hospital for rheumatology for the 8th consecutive year by U.S. News & World Report.
- The rankings, based on expert rheumatologist opinion rather than objective outcome data, spark debate about their clinical relevance.
- Cleveland Clinic and Hospital for Special Surgery (HSS) round out the top three, reflecting strong reputations in comprehensive rheumatologic care and research.
- The methodology and implications of such rankings warrant scrutiny, especially regarding translation to real-world clinical outcomes and patient decision-making.
Rheumatologic diseases—including rheumatoid arthritis, systemic lupus erythematosus, spondyloarthropathies, vasculitides, and connective tissue disorders—represent a substantial burden on global health, contributing to chronic pain, disability, and reduced quality of life. In the United States, it is estimated that nearly 54 million adults have some form of doctor-diagnosed arthritis or rheumatic disease, with significant direct and indirect healthcare costs (Barbour et al., 2017). The complexity of these conditions demands multidisciplinary expertise and access to advanced diagnostics, therapeutics, and coordinated care pathways.
Hospital rankings in rheumatology, such as those produced by U.S. News & World Report, are widely referenced by patients, clinicians, and policymakers. These rankings are intended to guide referral patterns, patient choice, and institutional investment. However, their methodology—particularly in rheumatology—relies on expert opinion surveys rather than metrics such as survival, complication rates, or patient-reported outcomes. This distinction is critical when evaluating the meaning and value of such rankings.
For the 2025-2026 cycle, U.S. News & World Report ranked U.S. hospitals in 15 specialties. In rheumatology, rankings are based exclusively on expert opinion, derived from annual surveys of board-certified rheumatologists. The eligible pool included respondents from 2022, 2023, and 2024, with the top 10 hospitals being those nominated by at least 5% of survey participants.
Objective performance metrics—including patient volumes, risk-adjusted outcomes, or adherence to guideline-based care—were not incorporated into the rheumatology rankings. This contrasts with other specialties (such as oncology or cardiology), where data-driven measures account for a substantial portion of the final score. The rankings are thus a reflection of perceived excellence and reputation among peers, rather than direct measurement of patient outcomes or service quality.
The 2025-2026 top 10 rheumatology hospitals are:
- Johns Hopkins Hospital, Baltimore
- Cleveland Clinic, Cleveland
- Hospital for Special Surgery (HSS), New York City
- Brigham and Women’s Hospital, Boston
- Mayo Clinic, Rochester, Minnesota
- Massachusetts General Hospital, Boston
- UCSF Health-UCSF Medical Center
- UCLA Medical Center
- NYU Langone Hospitals, New York City
- University of Michigan Health, Ann Arbor
Notably, the top nine hospitals remain unchanged from the previous year. The only shift was University of Michigan Health supplanting the University of Alabama at Birmingham Hospital for the No. 10 spot. An additional 18 hospitals received at least 1% of nominations, further indicating a relatively concentrated consensus among experts.
The reliance on expert opinion introduces several limitations:
- Subjectivity and Bias: Reputation-based surveys may perpetuate historic prestige and underrecognize emerging centers of excellence.
- Lack of Outcome Data: Without adjustment for case mix, complication rates, or patient satisfaction, the rankings may not correlate with real-world care quality.
- Geographic Disparities: Concentration of top-ranked hospitals in certain regions may limit access for rural or underserved populations.
- Potential Conflict of Interest: Academic and referral patterns may influence survey responses.
Recent literature has questioned the utility of hospital rankings for patient-centered decision-making, advocating for greater transparency and incorporation of objective metrics (Austin et al., 2015).
Opinion leaders have highlighted the value of large academic centers in driving innovation, education, and care of rare diseases, but also caution against overreliance on rankings when making clinical or referral decisions. The American College of Rheumatology emphasizes the importance of timely diagnosis, guideline-directed therapy, and shared decision-making, regardless of care setting (Singh et al., 2016).
Johns Hopkins Hospital’s continued leadership in the U.S. News & World Report rheumatology rankings reflects a well-established tradition of clinical excellence, research, and multidisciplinary care. However, given the expert-opinion–based methodology, these rankings should be interpreted with caution. They highlight centers of perceived excellence but are not definitive indicators of patient outcomes or universally superior care. For most patients, high-quality rheumatologic management is accessible in many settings. Future ranking systems would benefit from the integration of objective, patient-centered outcomes and broader stakeholder input.
References
- https://health.usnews.com/health-care/best-hospitals/articles/best-hospitals-honor-roll-and-overview
- Barbour KE, et al. Vital signs: prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2013–2015. MMWR Morb Mortal Wkly Rep. 2017;66(9):246-253.
- Smolen JS, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685-699.
- Austin JM, et al. National hospital ratings systems share few common scores and may generate confusion instead of clarity. Health Aff (Millwood). 2015;34(3):423-430.
- Singh JA, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2016;68(1):1-26.