The Leapfrog Group Announces Changes for 2021 Leapfrog Surveys of Hospitals and Surgery Centers

March 10, 2021

New Questions on Ethical Billing Practices and Health Inequity, along with COVID-19-Related Rule Changes

WASHINGTON—The Leapfrog Group, a national watchdog organization of employers and other purchasers focused on health care safety and quality, published changes to the 2021 Leapfrog Hospital Survey and Leapfrog Ambulatory Surgery Center (ASC) Survey.

Leapfrog has added two new sets of questions in 2021 to assess whether hospitals and surgery centers practice ethical billing and track and address disparities in care that affect patient care. Leapfrog’s employer constituency and multiple other stakeholders, along with compelling research, highlights the importance of ethical billing practices and attention to health inequity as important to patient outcomes.

“High-quality health care depends on two strong organizational values: putting the patient first every minute of every day, and unwavering commitment to transparency,” said Leah Binder, president and CEO of The Leapfrog Group. “That is why we decided to add billing ethics and health inequity to the Surveys, which demonstrate how a facility respects 100% of its patients and commits to transparency around those practices in the future.”

As per longstanding Leapfrog policy for new Survey content, the findings on these questions will not be scored or publicly reported by facility this first year.

In addition, due to the ongoing COVID-19 pandemic, The Leapfrog Group also implemented changes to the rules for submitting 2021 Surveys. While not as extensive as rule changes Leapfrog implemented when the 2020 Surveys launched at the onset of the pandemic in the U.S., they offer flexibility to facilities across the country at varied stages of COVID-19 recovery. Changes include a 30-day submission deadline extension, updated reporting periods for select sections of the Surveys, and reduced sample sizes for certain measures.

Other changes to the 2021 Hospital Survey include a new section on Nurse Staffing and Skill Level, updates to the Hand Hygiene section, and updates to the Computerized Physician Order Entry (CPOE) tool. Changes to the 2021 ASC Survey include new questions on minimum procedure volume and surgeon volume and a new section of Nursing Workforce. The full list and description of changes to the 2021 Leapfrog Hospital Survey can be found here, and the 2021 Leapfrog ASC Survey here.

Leapfrog received more than 150 public comments from health care organizations, as well as health care experts, patient advocates, and purchasers, in response to its proposed changes for the 2021 Leapfrog Hospital Survey and Leapfrog ASC Survey. The submitted comments were invaluable to the development of high-quality Surveys that serve Leapfrog’s many constituents, including purchasers, payors, hospitals, and the American public.

The 2021 Leapfrog Hospital Survey and Leapfrog ASC Survey will open on April 1, and a PDF of the Survey will be available for download on The Leapfrog Group’s website. The submission deadline is July 31, and the first results of the Surveys will be publicly available in early August.

For more information on the changes, please visit and 


About The Leapfrog Group

Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. The flagship Leapfrog Hospital Survey and new Leapfrog Ambulatory Surgery Center (ASC) Survey collect and transparently report hospital and ASC performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions. The Leapfrog Hospital Safety Grade, Leapfrog’s other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections.

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