Accessing high-quality healthcare in the United States has become increasingly complex. While technological advances have fostered extraordinary innovation in medicine and digital record keeping, the benefits have not always trickled down to patients. Many who seek medical services face fragmented care, confusing instructions, skyrocketing costs, excessive waits and risk of medical complications.

These shortcomings can be exacerbated by socioeconomic disparities, rendering the system especially challenging for those with fewer resources and those at their most vulnerable, managing illnesses or battling life-threatening conditions.

But if there is a cure for such ailments, it derives from knowledge. To that end, Forbes is debuting Forbes Top Hospitals 2026, a new tool—curated through extensive research and analysis—that is designed to provide consumers with unbiased information to help them choose the best hospitals for their healthcare needs. This inaugural hospital rating system aims to serve the interests of patients and provide healthcare leaders with empirical benchmarks to compare quality performance against their peers.

Forbes has focused the ratings on “general acute care hospitals.” These facilities offer a wide range of services for urgent and short-term medical needs, including: the management of emergencies and injuries (e.g. broken bones and burns), serious conditions (e.g. heart attack, stroke, pneumonia and diabetes), surgical care (e.g. appendectomy, knee and hip replacement), and childbirth. Unlike specialty hospitals—which typically focus on specific clinical areas and complex, high-risk cases—general acute care hospitals usually treat a greater number of common conditions, contain an emergency department (ED), and provide healthcare services for more people each year. So, unless it’s critical to go immediately to the closest hospital (which is usually a necessity in emergency situations), there are millions of hospital admissions annually, meaning millions of opportunities for people to choose where they get their care. The Forbes Top Hospitals ratings have been devised to better inform that decision.

Forbes’ Approach To Hospital Quality Ratings

Forbes Top Hospitals—formally, the Forbes Overall Hospital Quality Ratings (FOHQR)—are based on validated and objective indicators of outcomes, best practices, value and patient experience. Our methodology was created in consultation with healthcare measurement experts (including those at Inovalon, a healthcare technology and analytics firm that also calculated the ratings) and an advisory panel consisting of clinicians, scientists, health policy and healthcare management researchers, and patient advocates.

The ratings are distinct from other hospital ratings and rankings in numerous methodological ways. But these three elements in particular characterize our unique approach:

  • The primary quality measures evaluated in the methodology come from the Centers for Medicare and Medicaid Services (CMS) Provider Data Catalog (PDC), which are available here. Each quality measure assesses a key aspect of healthcare, such as health outcomes, patient perceptions, organizational structures and system processes. These publicly reported measures are then used to determine the degree to which healthcare services are delivered efficiently, effectively, safely and equitably—while providing high-quality care. Forbes chose these measures specifically because they have been developed and regularly vetted by stakeholders in the healthcare community to meet a high national standard. This consensus-driven process involves:
  1. Rigorous scientific testing to ensure the measures are reliable, consistent and accountable
  2. Analyses from technical expert panels
  3. Public comment, during which anyone can offer feedback on the measures
  4. Input from stakeholders ranging from clinicians, healthcare organizations, insurers and patients
  • The methodology has placed the most weight on clinical outcomes (such as rates of mortality, survival, infection and readmissions) so that outcomes have the most impact on each hospital’s overall rating.
  • The methodology has statistically adjusted those clinical outcomes for social drivers of health (SDOH)—such as socioeconomics, access to medical services, and the conditions in which people live—because SDOH have been shown to heavily impact outcomes. By adjusting for these factors in the communities surrounding each hospital, our ratings allow for a more level comparison of each hospital’s quality, despite differences between any given hospital’s location and patient population.

Methodology

Given that the foundation of the methodology is the Centers for Medicare and Medicaid Services (CMS) Provider Data Catalog (PDC), Forbes began by identifying a subset of quality measures from the CMS PDC to include in our analysis.

To do this, individual quality measures from the CMS PDC were further vetted and selected based on two primary factors. First, they were chosen because the measures were reliable proxies for healthcare performance. Second, the measures were chosen so that when grouped together, they reflected a balanced representation of various types of hospital quality measures (such as outcomes, process, structure and patient experience).

This process resulted in the selection of 56 publicly reported hospital quality measures for inclusion in the methodology. These measures—which, as noted above, have been established as reliable and verifiable indicators of healthcare quality—include hospital metrics such as “surgical site infection after colon surgery,” “30-day readmission after discharge,” “patients who left the emergency department before being seen,” and “inpatients who reported they were given information about recovery.”

Next, to determine the universe of hospitals in consideration for the Forbes Overall Hospital Quality Ratings, we began with the 5,397 general acute care hospitals listed in the CMS PDC.

From this initial pool of hospitals, the following types of hospitals were excluded:

  • Children’s hospitals. The quality measures included in Forbes’ methodology primarily assess adult care, and these facilities do not provide acute care medical services to adults.
  • Psychiatric hospitals. These facilities do not provide the types of acute care medical services that are assessed through the majority of quality measures included in our methodology.

After eliminating the hospitals described above, the pool of eligible hospitals totaled 4,601. From this group, we considered only hospitals that publicly reported minimum thresholds of the 56 quality measures in our methodology, which narrowed the number of eligible hospitals to 2,544.

Note that the majority of specialty hospitals (those that focus on specialties such as orthopedics, cancer and surgical care) and all VA hospitals did not meet the minimum thresholds set for the 56 quality measures identified in our methodology. Therefore, the final group of 2,544 hospitals eligible for evaluation in Forbes’ hospital ratings does not include most specialty hospitals and does not include VA hospitals.

To evaluate these remaining hospitals and calculate their ratings, Forbes and Inovalon next undertook a series of comprehensive analyses and steps. While the full methodology can be found here, the following steps were fundamental to determining the hospital ratings:

  • The 56 selected measures were grouped into four pillars (or categories): Outcomes (consisting of 25 measures), Best Practices (10 measures), Value (7 measures) and Patient Experience (14 measures). Each pillar was then assigned a weight based on a variety of factors that ultimately determined each pillar’s impact on a hospital’s overall rating. The pillar weights are: Outcomes (55% of the weight), Best Practices (20%), Value (15%) and Patient Experience (10%).
  • In order to compare ratings reported in different ways (for example, rates, ratios or percentages), each measure’s rating received a z-score that reflected its deviation from the overall mean. This allowed comparisons across measures and facilities.
  • Because the measure results included some extreme outliers with highly irregular ratings—which could reflect errors in the data—the statistical technique of Winsorization was used to reduce their influence.
  • Outcome measures were then adjusted for social drivers of health (SDOH) among the population living near the hospital based on each measure’s statistical relationship with these drivers. As noted above, societal and environmental factors—such as income and access to transportation—have been shown to impact health. For instance, a person without access to transportation is less likely to go to the doctor to get regular preventative medical care, which tends to lead to poorer health. Conversely, a person with sufficient resources who owns a car is more likely to have easy access to a doctor and to stay on top of preventative care, which tends to lead to better health. Adjusting outcome measures based on SDOH in a hospital’s geographical area is designed to level the playing field so that a hospital’s quality is evaluated in such a way that it factors in its location and the health of its patient population.
  • The Outcomes pillar was also adjusted based on how each hospital performed in specific measures compared to the national average. Hospitals that frequently scored significantly higher than the national average received an upward adjustment to the Outcomes pillar.
  • Then, a z-score from -3 to 3 was calculated for each of the four pillars.
  • These pillar z-scores were normalized and weighted to produce an overall score for each facility on a scale of 0 to 1.
  • This overall score for each facility was assigned an initial star rating on a scale of 1 to 5 stars, with 1 star representing lower performance and 5 stars representing higher performance. The stars represented the following percentiles:
  1. One star: 1st to 10th percentile
  2. Two stars: 11th to 30th percentile
  3. Three stars: 31st to 70th percentile
  4. Four stars: 71st to 90th percentile
  5. Five stars: 91st to 100th percentile
  • These initial star ratings were then tested—via a chi-square test—to ascertain any bias in the results based on hospital size (determined by number of beds in each facility). After stratifying the hospitals into four peer groups (small, medium, large, and very large), this testing showed there was a statistically significant correlation between hospital size and star ratings. Therefore, peer grouping was conducted to ensure more level comparisons between differently sized hospitals.
  • Finally, percentiles within each peer group were calculated, and in turn used to calculate the final Forbes Overall Hospital Quality Ratings.

The 2026 Ratings And Forbes Top Hospitals List

Based on the calculations and scoring process above:

  • 253 hospitals earned an overall rating of 5 stars
  • 509 hospitals earned an overall rating of 4 stars
  • These 4-and 5-star hospitals, totaling 762, made our inaugural Top Hospitals list.

Broken down by hospital size:

  • Small Hospitals (754 small hospitals were evaluated): 151 facilities earned 4 stars; 75 facilities earned 5 stars
  • Medium Hospitals (961 medium hospitals were evaluated): 192 facilities earned 4 stars; 96 facilities earned 5 stars
  • Large Hospitals (579 large hospitals were evaluated): 116 facilities earned 4 stars; 57 facilities earned 5 stars
  • Very Large Hospitals (250 very large hospitals were evaluated): 50 earned 4 stars; 25 earned 5 stars

How To Use Forbes Top Hospitals Ratings

Forbes Top Hospitals ratings are not medical advice. They can assist people in learning about different providers, but the ultimate choice for care should be made by the patient or their loved ones in consultation with their medical provider. In any emergency, call 911.

This rating system can also provide hospital leaders with a transparent and verifiable method through which they can compare their hospital’s performance to the performance of other facilities.

To see the full methodology, its contributors, and our advisory panel members, click here.

For frequently asked questions about the ratings, click here.

For the full list of Forbes Top Hospitals, click here.

To make these ratings as useful as possible to both patients and hospital leaders, Forbes welcomes your feedback. For any comments or questions about Forbes Overall Hospital Quality Ratings, please email: TopHospitals [at] forbes.com.

As with all Forbes lists, there is no fee to be considered or selected.