U.S. News & World Report, which has been ranking hospitals for 20 years, met with dozens of hospital leaders Thursday to discuss ways to improve its own list, which some doctors who head hospitals say is the best. Still, participants grappled with issues including how and whether to rate a hospital's "reputation," if a hospital's lower-income patient population should be factored into the rankings and whether a hospital's more advanced technology or even its ranking really relates to what a patient will actually experience there.