The annual ranking of U.S. hospitals by the news magazine U.S. News & World Report has long stirred controversy, particularly by the heavy weight it gives to hospital reputation as measured by the votes of just a few hundred American Medical Association member physicians. However, its influence in hospital marketing is undeniable.

Cracking the top spot for the first time this year was the Mayo Clinic, followed by similar name-brand institutions.

Roughly a third of a hospital’s rank is based on reputation, and as Michael Holers, M.D., head of the University of Colorado School of Medicine’s Division of Rheumatology, noted in a University publication last year, voters, like him, generally just put down the names of the institutions that first spring to mind, not necessarily the ones they know a great deal about personally.

“The program that comes most readily to mind, based on a long history or a recent mailing, is what you put down,” he said.

The American Hospital Association has pushed back against some of the influence of ratings. In 2012, it took Leapfrog Group to task for how it measured hospital safety in its annual report card rankings.

The Centers for Medicare and Medicaid Services’ efforts to make its quality and outcome data more accessible to beneficiaries is another possible way to reduce the influence of consumer-oriented lists like U.S. World News and Reports. However, until government data becomes a lot more accessible and easy to use, it is unlikely to pose much challenge to the influence of the popular U.S. World News and Reports annual rankings.