Patient experience scores have largely rebounded to or past pre-pandemic levels, but wide variation remains in whether patients can count on a consistent experience, according to Qualtrics’ “State of Patient Experience 2026” report.
The report, prepared by the firm’s XM Institute and released Nov. 12, draws on more than 43.1 million patient encounters from more than 2,500 hospitals and 490,000 medical office sites. Its analysis of variation across admission types is based on first-quarter 2026 scores from 1,670 hospitals.
Seven things to know:
1. Scores rose across nearly every setting.
Patient experience is measured on a 100-point scale reflecting the share of patients giving the most favorable response. “Likelihood to recommend” (LTR) climbed year over year in ambulatory surgery (85.3 to 86), medical practice (85 to 86), inpatient care (70.1 to 70.5) and the emergency department (68 to 69.5). Overall ratings improved in every setting except inpatient, which slipped from 70.4 to 69.7.
2. Operational friction is the sharpest drag on loyalty.
Patients who encountered friction — delayed appointments, scheduling hurdles, communication breakdowns and poorly coordinated handoffs — gave LTR scores 30 to 37 points lower than those who did not. Scores fell from 88.7 to 51.8 in ambulatory surgery, from 96.4 to 60.3 in medical practices and from 90.6 to 60.3 in inpatient care. The report frames these operational breakdowns as just as damaging to trust as clinical complexity.
3. The same hospital can deliver very different experiences.
National averages obscure how much depends on when, where and how patients enter the system — so much so that the report argues multiple “hospitals” can operate under one roof. At bottom-quartile hospitals for patient experience, overall ratings from patients with unplanned admissions trailed planned-stay patients by 18.2 points. At top-quartile hospitals, the gap was less than half that, at 8.9 points.
4. Consistent nursing practices narrow the gap.
Reliable execution of proven practices can outweigh the admission type. For example, unplanned-stay patients who received a bedside shift report gave higher recommendation scores than planned-stay patients who did not (76.5 vs. 68.3).
5. Disparities persist by race, age and visit type.
In emergency departments, Native Hawaiian/Pacific Islander, American Indian/Alaska Native, Asian and Black or African American patients consistently rated care below their facilities’ overall results, with the largest gap exceeding eight points. In medical practices, first-time patients rated their experience lower than returning patients (81 vs. 84.2). The ease-of-scheduling gap widened with age, from about 4 to 5 points for patients under 50 to more than 7 points for those 65 and older.
6. Teamwork is the strongest driver, and it shows up in clinical performance.
Caregiver teamwork and the trust it signals ranked as the top driver of patient confidence and loyalty. Hospital units with high employee-reported trust were 2.4 times as likely to earn top hospital ratings, and organizations with the strongest teamwork were 50% to 80% more likely to excel on key nursing quality measures.
A completed post-discharge call also mattered: those patients scored 17 percentile points higher on HCAHPS overall hospital rating and 12 points higher on LTR than patients reached only by an attempted call.
7. The 2027 directive is to fix systems, not scores.
The XM Institute urged leaders to reduce variation through consistent care practices, operational improvement and real-time feedback rather than chasing higher aggregate numbers.
“AI should amplify empathy, not replace it, by removing friction so caregivers can spend more time on what only people can do: explain, listen and reassure,” Thomas Lee, MD, executive director of the Qualtrics XM Institute, wrote in the report.
