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As U.S. News & World Report of "Best Children's Hospitals," the outlet also received new pushback on its rankings.

On Tuesday, San Francisco City Attorney David Chiu announced that he had sent a letter to U.S. News . The letter also urged the outlet to "publicly disclose the payments it receives from the hospitals it endorses, as required by federal regulations," Chiu said in the announcement.

The inquiry from the City Attorney comes amid a tumultuous time for U.S. News' rankings. This year's "Best Medical Schools" list was released last month after a delay, and it had substantially changed from a preview that was posted online in April and subsequently pulled ahead of the final rankings.

Furthermore, the delay in rankings came after a bevy of high-profile medical and law schools publicly announced their plans to no longer submit data to or participate in the rankings.

Nevertheless, U.S. News forged ahead in releasing its "Best Children's Hospitals" rankings on Tuesday.

As for this year's overall top performers, Cincinnati Children's Hospital Medical Center nabbed the No. 1 spot on the honor roll. In doing so, the hospital climbed two notches from a third-place finish last year.

Rounding out the top three were Boston Children's Hospital at No. 2 and Texas Children's Hospital in Houston at No. 3. Boston Children's placed first last year, and Texas Children's placed second.

"Parents of sick children face many difficult challenges, including how to identify the best children's hospital to treat their illness or condition," Ben Harder, chief of health analysis and managing editor at U.S. News, said in a statement accompanying the release of the rankings. "The rankings, which are increasingly determined by objective measures of hospital quality, can help them make informed decisions."

"Refinements" to this year's methodology included "less of an emphasis on expert opinion and an increase in weight on such measures as commitment to best practices and commitment to equity, diversity and inclusion," according to U.S. News.

Ultimately, though, methodology updates for a number of rankings have not been enough to ward off some of the criticism the outlet continues to receive.

"Consumers use these rankings to make consequential healthcare decisions, and yet there is little understanding that the rankings are fraught and that U.S. News has financial relationships with the hospitals it ranks," Chiu said in his announcement. "The hospital rankings appear to be biased towards providing treatment for wealthy, white patients, to the detriment of poorer, sicker, or more diverse populations."

"Perverse incentives in the rankings risk warping our healthcare system," he added. "Hospitals are treating to the test by investing in specialties that rack up the most points rather than in primary care or other worthy specialties."

In response to Chiu's letter, a spokesperson for U.S. News provided a statement to 番茄社区 in an email, noting that the outlet "categorically disagrees with the assumptions and conclusions in the City Attorney's letter."

"U.S. News is the leading trusted source for quality hospital rankings precisely because we do not in any way accept or engage in compensation for rankings placement," the spokesperson wrote, pointing out that its rankings are "based wholly on the data we analyze and detail in our transparent methodology, which is fully disclosed on USnews.com."

"Our esteemed journalists and data analysts who participate in creating the rankings take their responsibility to produce quality journalism very seriously, which has earned the trust of consumers for more than 30 years," the spokesperson added.

Below are the top 10 children's hospitals on this year's "Best Children's Hospitals" list. The full rankings, including top performers in different specialties and regions, are .

1. Cincinnati Children's Hospital Medical Center
2. Boston Children's Hospital
3. Texas Children's Hospital
4. Children's Hospital of Philadelphia
5. Children's National Hospital (Washington, D.C.)
6. Nationwide Children's Hospital (Columbus, Ohio)
7. Children's Hospital Los Angeles
8. UPMC Children's Hospital of Pittsburgh
9. Rady Children's Hospital (San Diego)
10. Johns Hopkins Children's Center (Baltimore)

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