CLEVELAND, Ohio — The Cleveland Clinic took the fourth-place spot overall in U.S. News & World Report’s Best Hospitals ratings, and earned the top nationwide ranking in cardiology and heart surgery for the 25th consecutive year.

“Year after year, for 21 years, we’ve been ranked in the top five. It goes up and down as the methodology changes,” said Dr. Herbert Wiedemann, who was named chief of staff for the Clinic last year. “We’re delighted to be ranked so consistently as one of the top hospitals in the country.”

Within Ohio, University Hospitals Cleveland Medical Center came in second, after the Clinic. Ohio State University Wexner Medical Center took third. Cleveland Clinic Fairview Hospital and Cleveland Clinic Hillcrest Hospital were ranked fourth and fifth, respectively.

In overall national hospital rankings, the Mayo Clinic in Rochester, Minnesota, took the top spot. Massachusetts General Hospital in Boston ranked second, followed by Johns Hopkins in Baltimore. New York-Presbyterian Hospital ranked fifth. In the previous three years of rankings, the Clinic was ranked second.

Ben Harder, managing editor and chief of health analysis at U.S. News, said that the 2019-20 Best Hospitals rankings should not be compared to previous year’s rankings because there were significant changes in the methodology this year. U.S. News added measures for patient experience and patient outcomes, as well as an enhanced risk-adjustment model that doesn’t penalize hospitals that treat sicker patients.

Those measures replaced things such as safety and mortality, on which the Clinic historically scored well, Wiedemann said.

“Take this year’s results on their own as much as possible,” Harder said.

The U.S. News report ranks hospitals nationwide on performance in 16 specialty areas, ranging from cancer to urology. Of the 4,500 hospitals analyzed by U.S. News, 165 were ranked nationally in at least one specialty.

“Our goal is less about differentiating between hospital No. 1 and No. 2 and more about differentiating the best hospitals in different specialties,” Harder said. “Patients don’t need a good hospital overall; they need a hospital that’s good at what they need.”

The Clinic had 15 specialties ranked nationally, six of which were ranked in the top five nationwide: cardiology/heart surgery (No. 1), rheumatology (No. 2), gynecology (No. 3), gastroenterology/GI surgery (No. 4), nephrology (No. 4) and urology (No. 4).

UH Cleveland Medical Center ranked in the top 50 nationwide in eight specialties: neurology/neurosurgery (No. 22), cardiology/heart surgery (No. 24), urology (No. 26), cancer (No. 30), ear/nose/throat (No. 39), gastroenterology/GI surgery (No. 28), nephrology (No. 34) and geriatrics (No. 45).

U.S. News’ hospital ratings may command more public attention, but there are a number of other hospital rankings, including the Leapfrog Group’s safety scores and the Centers for Medicaid and Medicare Services’ star rankings, which award hospitals an overall safety and quality score.