Hospitals by State

States with consistently high average CMS hospital ratings include Minnesota, South Dakota, Wisconsin, and Nebraska — largely rural Midwestern states where smaller community hospitals often outperform large urban medical centers on standardized quality metrics. Massachusetts and California have many top-ranked specialty hospitals despite average state ratings.

There are approximately 6,000 Medicare-certified hospitals in the United States. About 2,900 are community hospitals (non-federal, short-term). The US has roughly 924,000 staffed hospital beds. Texas, California, and New York have the most hospitals due to their large populations.

A 5-star hospital significantly outperforms national averages across mortality, safety, readmission, patient experience, and timely care measures. A 1-star hospital significantly underperforms. The difference in 30-day mortality rates between 1-star and 5-star hospitals can be 2-4 percentage points for conditions like heart failure and pneumonia.

Teaching hospitals (affiliated with medical schools) treat more complex cases and sicker patients, which can lower their CMS star ratings despite excellent clinical expertise. CMS does apply some risk-adjustment, but critics argue it doesn't fully account for case complexity. Teaching hospitals often rank lower on star ratings but higher on specialty care indices.