On March 30, Memorial Health System issued a news release that declared itself Chattanooga's only hospital to be named among the Top 100 in the nation.
Who said that? No less than Thomson Reuters, "the health care industry's leading source of information on hospital quality," the news release said.
Five months later, a similar announcement: "U.S. News & World Report ranks Erlanger No. 1 hospital in Chattanooga." Based on federal data, the magazine cited six specialties at Erlanger Health System as high performing - "far more than any other area hospital," officials said.
Soon it was Parkridge Health System's turn. On Sept. 14, the Joint Commission, "the leading accreditor of health care organizations in America," said Parkridge was "the only hospital system in Chattanooga" to follow correct patient care protocols at least 95 percent of the time.
So if all three Chattanooga hospitals claim to be the best, who's right?
The answer is complicated, and experts say patients shouldn't elevate any one hospital's claims since all three are marketing toward the same goal: Private and government insurers use quality measures to dole out hospital reimbursements.
Dr. Tom Lundquist, vice president of performance measurement and improvement at BlueCross BlueShield of Tennessee, said the insurance company doesn't "rely on any of the three rankings specifically."
"We look at processes of care, outcomes of care, patient safety and patient experience," he said, adding that some ranking systems consider only a few of those factors.
Erlanger and Parkridge representatives said they have mentioned or plan to mention their respective rankings in advertisements, but Memorial officials said they won't.
"There was a time when I thought it was important to advertise our rankings, regardless of where they came from," said Melissa Roder, vice president of quality at Memorial. "But it tends to confuse the public. We use them internally now, to remind providers the value they're providing our patients."
Parkridge, on the other hand, decided to advertise the Joint Commission findings because the findings are all publicly reported, Parkridge director of quality Karen Beam said. Patients, if they wanted to, could find the results by searching online, so there wasn't a reason not to advertise them, she said.
If patients want to determine which hospital is best for them, she said, they should check how they were ranked. Parkridge was ranked top performer based on care for heart attack, heart failure, pneumonia and surgeries.
"[Erlanger] will certainly incorporate this latest distinction in future advertising efforts, including a mention in our internal [telephone] on-hold message system," spokeswoman Pat Charles said. "This is a common practice for any hospital earning a high-performing rating from a national ranking agency. ... It serves as an opportunity for local consumers to gauge the caliber and type of health care available in their communities."
Patient advocates said people should rely on government comparisons instead of hospital promotions, but even those sometimes don't show the whole picture.
Patient-centered hospital data is collected by the Tennessee Department of Health. The state issues a comprehensive annual report and the information isn't broken down by hospital.
It's a little more specific at the federal level, where hospitals are ranked individually on the Hospital Compare website, which includes measures such as cleanliness, medical satisfaction and mortality rates.
Tennessee Hospital Association President Craig Becker said patients should prioritize their primary care provider's advice ahead of a list of honors.
"They're the ones who go to the hospitals, know the physicians there," Becker said. "They know what everybody's good at."
Officials from all three hospitals put competition aside to acknowledge what they see as the bigger picture.
"I think this is another feather in Chattanooga's hat, having all three major health care providers recognized by three separate national rating agencies," Erlanger's Charles said. "It says a lot about the level of health care available in this city."
Staff writer Andrew Pantazi contributed to this report.