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Guide · Comparing hospitals

Choosing Between Hospitals

A practical guide to using quality data, safety scores, and procedure volume to make an informed decision.

The short answer

For complex procedures, hospital volume and surgeon experience predict outcomes better than the overall star, so for any planned stay, weigh infection rates and condition-specific measures over the headline rating.

By the numbers

What the CMS data shows

5,426
Hospitals tracked
3.1 / 5
Avg CMS star rating
288 · 10%
Five-star hospitals

National CMS star-rating distribution

How all 2,866 rated Medicare hospitals break down across the 1–5 star scale

hospitals

What this shows Most hospitals cluster in the 3–4 star range; only 10% reach five stars and a similar share sit at one star, the headline rating is a relative ranking, not a pass/fail mark.

Source CMS Hospital Compare, overall hospital rating As of 2026

According to the Centers for Medicare & Medicaid Services (CMS), these figures cover 5,426 Medicare-certified hospitals as of March 2026, read our methodology for how the data is compiled.

The comparisons below use Centers for Medicare & Medicaid Services (CMS) Hospital Compare data covering 5,426 Medicare-certified hospitals, refreshed March 2026, see our methodology.

The Most Important Factor: What Are You Going For?

Hospital quality is not a single dimension. A hospital that excels at cardiac surgery may be average for joint replacement. A teaching center with the latest oncology technology may have below-average patient experience scores. Before looking at any quality data, be specific about what you need:

  • Is this an emergency or a planned procedure?
  • Is your condition common (heart failure, pneumonia) or complex/rare?
  • Does your condition require subspecialty care or specialized equipment?
  • What is your priority, minimizing clinical risk, recovery experience, or convenience?

For emergencies, go to the nearest appropriate facility. For planned care, you have time to compare, and the data to do it.

Which Metrics Matter Most: A Practical Hierarchy

Not all CMS quality measures are equally useful for hospital selection. Some measure things largely outside the hospital's control (risk-adjusted mortality for very complex patients). Others measure things directly within the hospital's control and directly relevant to your risk.

Hospital quality metrics by relevance for patient decision-making
Metric Decision Relevance Why It Matters Best For
Hospital-acquired infection rates Very High Directly in hospital's control; directly affects your risk during any admission All planned admissions, especially surgery
Condition-specific mortality rates High Reflects actual outcomes for your condition; risk-adjusted to account for patient severity Heart attack, stroke, heart failure, pneumonia
Procedure volume (not in CMS data) High Strongly predicts outcomes for complex procedures, ask the hospital directly Complex surgery, cancer treatment, rare conditions
Readmission rates Moderate Reflects discharge planning quality; partly influenced by patient social factors outside hospital control Chronic condition management, heart failure, COPD
Patient experience (HCAHPS) Moderate Measures satisfaction with communication and environment; linked to care adherence Long stays, recovery-intensive care, pediatrics
Overall star rating Low–Moderate Good screening tool; hides procedure-specific performance and has systematic biases Initial screening only

When to Travel for Care

For some conditions and procedures, the evidence for going to a higher-volume center is overwhelming. Published research consistently shows:

  • Pancreatic surgery - mortality at low-volume hospitals (<10 cases/year) can be 10–15% vs 2–5% at high-volume centers (>50 cases/year)
  • Esophageal cancer surgery - similar volume-outcome relationship; major complications are significantly more common at low-volume centers
  • Complex cardiac surgery (aortic valve replacement, coronary bypass) - hospitals performing <100 procedures/year have worse outcomes than those doing 500+
  • Bariatric surgery - complication and mortality rates are substantially lower at accredited bariatric centers of excellence

For these complex procedures, traveling even several hours to a specialized center is generally worth it. For routine procedures (uncomplicated hernia repair, gallbladder removal, knee replacement at a high-quality local hospital), the evidence for travel is much weaker.

Using Infection Rates as a Selection Filter

Hospital-acquired infections are among the most actionable quality signals for patients. Unlike mortality rates (affected by how sick patients are) or readmission rates (affected by social factors), infection rates primarily reflect hospital practices: hand hygiene compliance, sterile technique, catheter care protocols, and environmental cleaning.

CMS reports infection rates as Standardized Infection Ratios (SIR): a value of 1.0 means exactly the national average, below 1.0 means better than average, above 1.0 means worse. For surgical patients, focus on:

  • Central line-associated bloodstream infections (CLABSI) - reflects ICU care quality
  • Surgical site infection rates, reflects sterile technique and antibiotic protocols
  • MRSA bacteremia, reflects overall infection control culture

Browse individual hospital pages on PlainHospital to see infection SIR data alongside star ratings and other quality measures. Check state rankings to find the safest hospitals in your area.

Red Flags in Hospital Quality Data

Certain data patterns should prompt serious consideration of alternatives:

  • SIR > 1.5 on multiple infection types - suggests systemic infection control problems, not random variation
  • 1-star on Safety of Care - the category most directly within the hospital's control
  • Below-average mortality on your specific condition - especially if it persists over multiple reporting periods
  • Significantly higher than average readmission rates for your condition, may indicate inadequate discharge planning or follow-up systems

Frequently Asked Questions

How far should I be willing to travel for a better hospital?

For elective procedures with significant risk, major joint replacement, cardiac surgery, complex cancer surgery, research consistently shows better outcomes at high-volume centers even if they require travel. For emergencies, always go to the nearest appropriate facility. For routine inpatient care (pneumonia, uncomplicated surgery), a high-quality local hospital is usually the right choice. The time and logistical burden of travel must be weighed against potential quality differences.

What is a Leapfrog safety grade and how does it differ from CMS stars?

The Leapfrog Group assigns A, B, C, D, F letter grades to hospitals based on patient safety specifically, measuring errors, accidents, injuries, and infections. Unlike CMS stars (which balance safety, mortality, readmission, patient experience, and process measures equally), Leapfrog focuses almost entirely on preventing avoidable harm. A hospital can be 5-star CMS but score B or C on Leapfrog if its patient experience scores are high but safety measures are average.

Should I choose a teaching hospital or a community hospital?

It depends on what you need. Teaching hospitals (with residency programs) often have more specialists and subspecialists available, are better equipped for rare or complex conditions, and tend to have more cutting-edge technology. For straightforward, well-understood conditions, a high-quality community hospital may have equally good outcomes with fewer complications, some studies show higher surgical complication rates at teaching hospitals for routine procedures due to trainee involvement.

How important is hospital volume for my specific procedure?

Volume-outcome relationships are well-established for complex procedures. For pancreatic surgery, esophageal cancer surgery, complex cardiac surgery, and bariatric surgery, patients at high-volume centers (100+ procedures/year) have substantially lower mortality rates than at low-volume centers. For routine procedures (uncomplicated joint replacement, gallbladder removal, appendectomy), volume matters less and a high-quality community hospital is likely appropriate.

How do I get information about a specific hospital's infection rates?

PlainHospital provides CMS-published infection data including MRSA, C. difficile, central line bloodstream infections, catheter-associated UTIs, and surgical site infections, reported as standardized infection ratios (SIR) where values below 1.0 indicate better-than-average performance. You can view this data for any hospital in the database.

What questions should I ask my doctor when choosing a hospital?

Ask: Which hospital do you have privileges at for this procedure? How often do you and your team perform this procedure here? What is this hospital's complication rate for this procedure? Does this hospital have a specialized program or unit for my condition? If something goes wrong, what resources does this hospital have available (ICU, cardiac cath lab, stroke team)? Your surgeon's volume and skill matter as much as the hospital itself.

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Quality data sourced from the CMS Hospital Compare program. Volume-outcome research findings cited from published peer-reviewed literature (Birkmeyer et al., Dimick et al., and others). This is educational content, not medical advice. Always consult your physician for guidance specific to your condition and local options.

Every figure on PlainHospital is rendered directly from federal source data, no number is typed in by an editor. This page draws directly on federal source data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.