States ranked

Which states have the best hospitals, and where does care cost the most? Every state is ranked here on four things that can be measured for all of them: hospital quality ratings, what patients say, how long the emergency room takes, and how far hospitals mark up their prices. The overall place is the average of the four.

Also:Best hospitals by state State report cards

Nebraskaranks first overall

Utahbest on quality: 79% US 41%

Iowabest on patient experience: 79% US 71%

North Dakotabest on ER time: 1 h 45 min US 2 h 28 min

Marylandbest on prices: $1.44 US $4.74

The top 10 overall

1Nebraska93 hospitalsQuality5th 63%Patient experience3rd 78%ER time3rd 1 h 54 minPrices14th $3.68 2South Dakota61 hospitalsQuality3rd 69%Patient experience5th 78%ER time2nd 1 h 52 minPrices24th $4.09 3Minnesota137 hospitalsQuality6th 62%Patient experience17th 74%ER time11th 2 h 6 minPrices6th $2.99 4North Dakota47 hospitalsQuality23rd 40%Patient experience8th 76%ER time1st 1 h 45 minPrices9th $3.26 5Iowa118 hospitalsQuality19th 43%Patient experience1st 79%ER time6th 1 h 59 minPrices16th $3.72 6Utah52 hospitalsQuality1st 79%Patient experience3rd 78%ER time14th 2 h 9 minPrices27th $4.16 7Idaho48 hospitalsQuality20th 43%Patient experience6th 77%ER time10th 2 h 5 minPrices12th $3.44 8Hawaii23 hospitalsQuality14th 45%Patient experience12th 75%ER time13th 2 h 8 minPrices11th $3.43 9Wyoming33 hospitalsQuality23rd 40%Patient experience20th 73%ER time7th 2 h 0 minPrices3rd $2.68 10Kansas139 hospitalsQuality26th 40%Patient experience2nd 79%ER time5th 1 h 57 minPrices21st $3.95

Overall place: darker is better

#52–#42
#42–#32
#32–#21
#21–#11
#11–#1

Every state

Click a column to sort. Each cell shows the state's place on that measure and the figure behind it.

Overall	State	Quality	Patient experience	ER time	Prices	Billed vs. paid*	Charity care*	Rated hospitals
1	Nebraska	563%	378%	31 h 54 min	14$3.68	173.8×	490.6%	35
2	South Dakota	369%	578%	21 h 52 min	24$4.09	274.3×	450.8%	16
3	Minnesota	662%	1774%	112 h 6 min	6$2.99	83.3×	401.0%	55
4	North Dakota	2340%	876%	11 h 45 min	9$3.26	73.2×	480.7%	15
5	Iowa	1943%	179%	61 h 59 min	16$3.72	194.0×	430.8%	60
6	Utah	179%	378%	142 h 9 min	27$4.16	143.6×	63.8%	28
7	Idaho	2043%	677%	102 h 5 min	12$3.44	284.4×	470.7%	21
8	Hawaii	1445%	1275%	132 h 8 min	11$3.43	113.4×	510.5%	11
9	Wyoming	2340%	2073%	72 h 0 min	3$2.68	53.0×	261.6%	15
10	Kansas	2640%	279%	51 h 57 min	21$3.95	455.9×	460.7%	53
11	Montana	3337%	1176%	41 h 55 min	8$3.09	42.9×	381.2%	19
12	Wisconsin	464%	876%	182 h 16 min	26$4.11	163.8×	341.2%	84
13	Oregon	1644%	1275%	292 h 35 min	7$3.05	63.2×	112.9%	43
14	Colorado	272%	876%	172 h 14 min	48$6.22	507.4×	162.2%	47
15	Maine	2839%	1873%	302 h 36 min	5$2.99	133.6×	500.6%	23
16	Alaska	3830%	677%	162 h 10 min	23$3.98	435.6×	351.2%	10
17	Oklahoma	1545%	1675%	82 h 2 min	44$5.58	405.2×	311.4%	60
18	New Hampshire	1843%	2372%	242 h 28 min	20$3.92	184.0×	201.9%	23
19	Rhode Island	760%	2571%	483 h 38 min	13$3.60	32.7×	361.2%	10
20	Indiana	1744%	2172%	212 h 20 min	38$4.98	334.7×	251.6%	89
21	Mississippi	5210%	1873%	92 h 4 min	19$3.86	324.6×	83.1%	50
22	Louisiana	4423%	1275%	112 h 6 min	32$4.50	385.1×	281.5%	57
23	Texas	1247%	2172%	192 h 17 min	49$6.38	486.8×	17.8%	211
24	Ohio	1052%	3370%	282 h 35 min	33$4.63	244.3×	241.7%	125
25	West Virginia	4717%	1275%	202 h 18 min	25$4.11	224.1×	420.9%	30
26	Vermont	4027%	2372%	402 h 55 min	4$2.73	214.1×	411.0%	11
27	Massachusetts	3138%	3171%	473 h 31 min	2$2.67	22.7×	440.8%	53
28	Virginia	859%	3171%	342 h 42 min	39$5.10	314.5×	142.4%	73
29	Missouri	2739%	3370%	262 h 31 min	29$4.36	304.5×	182.1%	76
30	Connecticut	1148%	4368%	453 h 18 min	18$3.80	103.4×	321.3%	25
31	Arkansas	4124%	2571%	152 h 9 min	37$4.96	204.0×	93.0%	41
32	Pennsylvania	954%	2571%	443 h 8 min	41$5.26	445.8×	301.4%	126
33	Washington	3038%	2571%	362 h 47 min	28$4.33	294.4×	132.4%	58
34	North Carolina	2142%	2571%	433 h 7 min	31$4.44	153.7×	103.0%	86
35	South Carolina	1347%	3370%	322 h 38 min	42$5.38	395.2×	54.0%	47
36	Michigan	3237%	4368%	312 h 37 min	15$3.71	93.4×	391.1%	92
37	Maryland	2939%	4766%	504 h 1 min	1$1.44	11.1×	172.2%	41
38	Alabama	5116%	2571%	232 h 27 min	30$4.41	425.5×	152.3%	56
39	Kentucky	4323%	3370%	212 h 20 min	36$4.88	344.9×	291.4%	65
40	California	2241%	3870%	392 h 54 min	40$5.15	466.3×	331.3%	271
41	New York	4224%	4766%	463 h 24 min	10$3.36	375.0×	371.2%	128
42	Illinois	3436%	3969%	382 h 53 min	35$4.83	254.3×	191.9%	132
43	Georgia	3732%	3370%	342 h 42 min	43$5.55	354.9×	26.8%	82
44	Florida	3535%	4368%	252 h 29 min	50$7.95	497.1×	35.6%	162
45	Tennessee	3635%	4169%	332 h 41 min	47$6.21	365.0×	44.3%	69
46	New Jersey	2340%	4965%	423 h 5 min	45$5.72	476.5×	73.2%	60
47	Nevada	4522%	3969%	272 h 32 min	51$11.37	519.1×	221.8%	23
48	Delaware	4717%	5064%	493 h 42 min	17$3.73	123.5×	122.5%	6
49	New Mexico	4618%	4667%	372 h 48 min	34$4.65	234.3×	231.8%	22
50	Arizona	3929%	4169%	413 h 0 min	46$6.03	415.4×	211.9%	52
51	District of Columbia	4717%	5163%	525 h 27 min	22$3.95	264.3×	271.6%	6
52	Puerto Rico	4717%	5163%	514 h 39 min	–	–	–	6

* Shown for comparison; not part of the overall place.

Quality: hospitals with 4 or 5 CMS stars

Highest: Utah (79%), Colorado (72%), South Dakota (69%). Lowest: Mississippi (10%), Alabama (16%), West Virginia (17%). United States: 41%.

Hospitals with 4 or 5 CMS stars, share of rated hospitals

10%–24%
24%–37%
37%–41%
41%–48%
48%–79%

Patient experience: patients who would definitely recommend the hospital

Highest: Iowa (79%), Kansas (79%), Nebraska (78%). Lowest: Puerto Rico (63%), District of Columbia (63%), Delaware (64%). United States: 71%.

Patients who would definitely recommend the hospital, typical hospital

63%–69%
69%–71%
71%–72%
72%–75%
75%–79%

ER time: typical emergency room visit

Shortest: North Dakota (1 h 45 min), South Dakota (1 h 52 min), Nebraska (1 h 54 min). Longest: District of Columbia (5 h 27 min), Puerto Rico (4 h 39 min), Maryland (4 h 1 min). United States: 2 h 28 min.

Typical emergency room visit, typical hospital

1 h 45 min–2 h 6 min
2 h 6 min–2 h 20 min
2 h 20 min–2 h 37 min
2 h 37 min–3 h 4 min
3 h 4 min–5 h 27 min

Prices: list price for every $1 of cost

Lowest: Maryland ($1.44), Massachusetts ($2.67), Wyoming ($2.68). Highest: Nevada ($11.37), Florida ($7.95), Texas ($6.38). United States: $4.74.

List price for every $1 of cost, typical hospital

$1.44–$3.43
$3.43–$3.95
$3.95–$4.44
$4.44–$5.26
$5.26–$11.37

How the ranking works, and its limits.

A state is ranked from best to worst on each of four measures; its overall place is the average of those four ranks, each counting the same. CMS does not rank states: the choice of measures and equal weights is ours.
"Typical hospital" is the median hospital in the state. Quality counts hospitals CMS has rated, leaving out Veterans Affairs and military hospitals.
States with few hospitals move a lot when one hospital changes. The last column shows how many rated hospitals stand behind each state's figures.
Prices here means list-price markup, which matters most to uninsured and out-of-network patients. It is not what insured patients pay.
Charity care depends heavily on how many residents are uninsured, which is set by state Medicaid rules, so it is shown but not scored.

Sources: CMS Care Compare (star ratings, patient survey, ER times), CMS hospital cost reports (markup, charity care) and Medicare inpatient data (billed and paid). How the numbers work.