The Leapfrog Group is making changes to the 2021 Leapfrog Hospital Survey and Leapfrog Ambulatory Surgery Center (ASC) Survey to address healthcare equity and ethical billing practices. The findings on the new questions will not be scored or publicly reported by facility for the first year.

Leapfrog also is changing some rules for submitting 2021 surveys, intended to provide flexibility to healthcare organizations still struggling with COVID-19 cases. The changes include offering a 30-day submission deadline extension, smaller samples for some metrics, and different reporting periods for certain survey sections.

There also will be a new section on Nurse Staffing and Skill Level, along with updates to the Hand Hygiene section and the Computerized Physician Order Entry (CPOE) tool.1

With the new question on healthcare equity, Leapfrog is encouraging hospitals to analyze their quality and safety data by race, ethnicity, or language, says Leah Binder, president and CEO of The Leapfrog Group. If they do, Leapfrog asks what they do with that information and any gaps that are discovered.

“This is the first year that we have asked this set of questions. Whenever we ask something new on the survey, we don’t report by facility on that metric,” Binder says. “But next year we will because we think the issue of healthcare disparities is urgent. We’ve seen this year a high level of awareness from both inside and outside of healthcare about what a problem this is.”

Leapfrog’s overall goal is to study what could change in the delivery of healthcare services to improve outcomes. The revised survey tries to determine what is causing disparities. Leapfrog is asking the same question of ASCs, Binder says, because the problem is ubiquitous.

“There may be racism, unequal treatment, unconscious bias, or other forces at work within an organization that may be causing care to be delivered in different ways,” Binder says. “We do know there is enough research to suggest there is a problem, and we can address it. We want health systems to start identifying this problem and look for models to address it.”

Binder says Leapfrog is learning about healthcare equity disparities along with hospitals and health systems. She does not suggest there is any simple or quick remedy.

“But we all have to learn really fast. This is outrageous, and we need to solve this problem,” Binder says. “We are asking hospitals what they have been doing to address it, and we hope they have been addressing it. This isn’t a new phenomenon, but we’re going to find out who’s addressing it, who’s doing a good job of that, and use that information as practice insights to share with the rest of the healthcare system.” 


  1. The Leapfrog Group. Summary of changes to the 2021 Leapfrog Hospital Survey & responses to public comments. Published March 8, 2021.


  • Leah Binder, President and CEO, The Leapfrog Group, Washington, DC. Phone: (202) 292-6713.