The 2017-18 U.S. News and World Report best hospitals list once again has the Mayo Clinic sitting on top, with Cleveland Clinic remaining No. 2 while Massachusetts General Hospital, No. 1 in 2015-16, fell to fourth place behind Baltimore’s Johns Hopkins Hospital.

It’s the second straight year Mayo has topped the Honor Roll, naming 20 hospitals which “deliver exceptional treatment across multiple areas of care.” Mayo was no. 1 in six of the 28 specialty, procedures and conditions categories: Diabetes & Endocrinology, Gastroenterology & GI Surgery, Geriatrics, Gynecology, Nephrology and Neurology & Neurosurgery.

“Mayo Clinic is consistently top ranked nationwide more often than any other hospital because of the thousands of people here who shared a vision,” Mayo Clinic President and CEO John Noseworthy, MD, said in a statement. “Our physicians, scientists, researchers, educators and allied health staff bring their expertise to focus on the individual needs of each patient.”

Here’s the complete Honor Roll and how each hospital’s rankings compare to last year’s top 20:

1. Mayo Clinic, Rochester, Minn. (1st in 2016)
2. Cleveland Clinic (2nd)
3. Johns Hopkins Hospital, Baltimore (4th)
4. Massachusetts General Hospital, Boston (3rd)
5. UCSF Medical Center, San Francisco (7th)
6. University of Michigan Hospitals and Health Centers, Ann Arbor (18th)
7. Ronald Reagan UCLA Medical Center, Los Angeles (5th)
8. New York-Presbyterian Hospital, N.Y. (6th)
9. Stanford Health Care-Stanford Hospital, Stanford, Calif. (14th)
10. Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia (9th)
11. Cedars-Sinai Medical Center, Los Angeles (17th)
12. Barnes-Jewish Hospital, St. Louis (11th)
13. Northwestern Memorial Hospital, Chicago (8th)
14. UPMC Presbyterian Shadyside, Pittsburgh (12th)
15. University of Colorado Hospital, Aurora (20th)
16. Thomas Jefferson University Hospitals, Philadelphia (Not in Honor Roll in 2016-17)
17. Duke University Hospital, Durham, N.C. (16th)
18. Mount Sinai Hospital, New York (15th)
19. NYU Langone Medical Center, New York (10th)
20. Mayo Clinic Phoenix (Not in Honor Roll in 2016-17)

This year’s lists reflected several methodology changes. For ratings on procedures and conditions, five years of Medicare data were used instead of three. Those ratings were also more greatly emphasized in the regional rankings over specialty data. U.S. News also said it “improved” its measurements on accounting for transfer patients and socioeconomic data to “avoid penalizing hospitals for treating low-income patients or for accepting high-risk cases transferred from other hospitals.”

The top hospitals in other specialties, procedures and conditions where the Mayo Clinic isn’t ranked No. 1 are:

• Cancer: University of Texas MD Anderson Cancer Center
• Cardiology & Heart Surgery: Cleveland Clinic
• Ear, Nose & Throat: Johns Hopkins Hospital
• Ophtalmology: Bascom Palmer Eye Institute-Anne Bates Leach Eye Hospital, Miami, Fla.
• Orthopedics: Hospital for Special Surgery, New York
• Psychiatry: McLean Hospital, Belmont, Mass.
• Pulmonology: National Jewish Health, Denver-University of Colorado Hospital
• Rehabilitation: Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago)
• Rheumatology: Johns Hopkins Hospital
• Urology: Cleveland Clinic