More than 3,700 hospitals — roughly 85% of U.S. acute care and critical access hospitals — received a score from at least one of five major hospital rankings this year.
Becker’s compiled and compared the 2026 results of U.S. News & World Report‘s Best Hospitals, the CMS Overall Hospital Quality Star Ratings, Forbes‘ Top Hospitals, the Lown Institute Hospitals Index for Social Responsibility and The Leapfrog Group’s spring safety grades to see where they agree, where they diverge and what separates them.
Facilities were tracked across all five rankings using their CMS Certification Number, the identifier Medicare assigns each facility, so a hospital listed under different names on different rankings is counted once rather than several times.
The rankings:
- U.S. News & World Report’s Best Hospitals 2026-2027, published Aug. 4, analyzed nearly 4,500 hospitals across 14 specialties and 23 procedures and conditions. This edition brought substantial methodology changes to increase the weight of risk-adjusted outcomes compared to previous years.
- CMS Overall Hospital Quality Star Ratings, last updated April 28, is the only non-curated list as every Medicare-certified facility (5,432 in total) is included. CMS star ratings, which range from one to five, reflect several metrics including mortality, safety, patient experience and timely care.
- Forbes Top Hospitals 2026, published Dec. 4, 2025, scores 2,598 general acute care hospitals on 56 CMS measures across four weighted pillars: outcomes (55%), best practices (20%), value (15%) and patient experience (10%). Unlike other rankings, this list adjusts outcomes for social drivers of health and sorts hospitals into peer groups by bed count before assigning stars.
- Lown Institute Hospitals Index for Social Responsibility 2026, released June 23, grades 3,618 hospitals based on three weighted sections: 40% equity, 30% value and 30% outcomes. The equity category includes pay equity between CEOs and hourly employees, charity care and community investment. Nothing comparable appears in any other ranking here.
- The Leapfrog Group Hospital Safety Grade Spring 2026, released May 6, assigned letter grades using up to 22 CMS patient safety measures plus its own voluntary hospital survey. This biannual cycle came with a caveat: Leapfrog did not grade 450 hospitals that had not completed the survey after a federal judge ruled in March that five Florida hospitals had been deliberately assigned artificially low scores for declining to participate.
Here are nine takeaways from the analysis.
1. The four major rankings almost never pick the same hospital. Of the 5,432 hospitals assessed, just three were included among U.S. News‘ Best Regional Hospitals, Forbes and CMS’ five-star hospitals and Lown’s honor roll:
- Alta Bates Summit Medical Center (Oakland, Calif.)
- University of Kansas Hospital (Kansas City)
- MedStar Union Memorial Hospital (Baltimore)
Another 76 were recognized with three of four awards, and 4,467 did not receive any. The highest overlap (22.9%) occurred between Forbes‘ and CMS’ five-star lists with 120 hospitals recognized on both. Meanwhile, Lown and Forbes‘ had the least overlap at just 16 hospitals, or 4%.
| Overlap | Agreement | |
| Forbes five-star vs. CMS five-star | 120 hospitals | 22.9% |
| U.S. News Best Regional vs. CMS five-star | 131 | 17.4% |
| U.S. News Best Regional vs. Forbes five-star | 96 | 14.5% |
| Lown Honor Roll vs. CMS five-star | 29 | 5.6% |
| U.S. News Best Regional vs. Lown Honor Roll | 32 | 5.1% |
| Forbes five-star vs. Lown Honor Roll | 16 | 4.0% |
2. Lown and U.S. News disagree — but not about clinical quality.
Only two of the 20 U.S. News Honor Roll hospitals appear on Lown’s 2026 acute care Honor Roll: The Johns Hopkins Hospital (Lown rank 69) and The Mount Sinai Hospital (rank 114). Across the wider list, 32 of 501 Best Regional Hospitals made Lown’s Honor Roll.
However, Lown’s honorees sit essentially where U.S. News‘ honorees sit on the federal government’s own clinical scorecard, and both sit well above the national average. Mean CMS star rating:
- Lown Honor Roll: 3.70
- U.S. News Best Regional Hospitals: 3.81
- All rated acute care hospitals nationally: 3.16
In total, 103 of Lown’s 160 honorees appear on none of the other three lists. The main reason for this divergence is that equity carries 40% of Lown’s composite score.
3. For-profit hospitals are underrepresented. For-profit hospitals represent about 23.6% of U.S. acute care hospitals, but their share among award recipients was less than 11% across every ranking. Among the 1,677 hospitals U.S. News evaluated, the mean High Performing count was 3.67 for for-profits vs. 6.17 for nonprofits.
| List | For-profit share | vs. expected |
| U.S. News Honor Roll | 0.0% | 0.00× |
| U.S. News Best Regional | 7.0% | 0.30× |
| Forbes five-star | 8.5% | 0.37× |
| Lown Honor Roll | 9.4% | 0.41× |
| U.S. News Community Access | 9.9% | 0.43× |
| CMS five-star (acute only) | 10.7% | 0.46× |
4. Forbes‘ bed-size peer grouping redrew the map. Forbes is the only ranking of the five that sorts hospitals into peer groups by bed count before scoring (<100, 100-249, 250-499, 500+) and the only one that adjusts outcomes for social drivers of health. The publication recognized 19 five-star hospitals in Wisconsin — more than California (16), Texas (16) or Ohio (16), from roughly a quarter as many hospitals. In addition, 163 of the 259 Forbes five-star hospitals are not U.S. News Best Regional Hospitals.
5. CMS leaves a third of eligible hospitals unrated. About 32% of the 4,493 acute care and critical access hospitals included in the dataset carry no overall star rating. Seventy-one percent of critical access hospitals and 14% of acute care hospitals went unrated. Unrated acute care hospitals skewed sharply for-profit: 212 of 445 were proprietary or physician-owned (48%), against 23% of acute care hospitals overall. CMS does not calculate ratings for facilities with too few measures or measure groups reported, or for facilities that don’t participate in the Inpatient or Outpatient Quality Reporting programs.
6. VA hospitals are the biggest winner that nobody counts. Fifty of 132 Veterans Affairs’ hospitals hold a five-star rating from CMS. This equates to 38% of the VA system, compared to 11% of rated acute care hospitals nationally. Despite being 2.4% of all facilities, VA hospitals make up 13% of CMS’ 384 five-star hospitals.
VA hospitals appear on zero of the other “top hospital” lists in 2026. U.S. News, Forbes and Lown all exclude federally owned hospitals by design.
7. U.S. News built a category similar to Lown’s. The U.S. News’ Best Regional Hospitals for Community Access is new in 2026, and the 73 honored hospitals look measurably different from other U.S. News’ honorees. The “best regional community access” hospitals have a mean CMS star of 3.39, while the “all best regional” hospitals hold a 3.81 average CMS star. In the former group, about 20% have one or two CMS stars, compared to 9.4% in the latter.
Compared to Lown’s Honor Roll, 13% are on U.S. News’ “community access” ranking and 6% are on the “all best regional” list.
8. Leapfrog suspended grading for 450 hospitals in spring 2026. Its winners do not match other rankings.
In spring 2026, Leapfrog did not assign safety grades to 450 hospitals that did not complete its voluntary survey, after a federal judge ruled in March that five Tenet-owned Palm Beach (Fla.) Health Network hospitals had been deliberately assigned artificially low scores for not participating. Leapfrog has said it expects to resume full grading in fall 2026.
Leapfrog’s 11 straight-“A” hospitals, or those that have consecutively received an “A” since 2012, have minimal overlap with other lists:
- 4 of 11 are Forbes five-star
- 0 of 11 are on Lown’s Honor Roll
- CMS stars range from 3 to 5
- 8 of 11 are U.S. News Best Regional Hospitals
In 2026, three of the five majors rankings changed their own rules. Leapfrog suspended part of its program under a court ruling. U.S. News deleted every structural measure, rebuilt cardiology from 45% to 80% outcomes-weighted, and dropped ear, nose and throat as a ranked specialty. Forbes changed its qualification thresholds six weeks after launch, adding 54 hospitals — 46 of them small — and rewrote its star percentile bands.
9. About 100 hospitals are ranked top-notch. Of the 1,838 hospitals ranked by U.S. News, each specialty ranking includes only 186 hospitals, or 10% of the rated field. Three rank in all 14 specialties: Johns Hopkins in Baltimore, Mayo Clinic Rochester (Minn.) and NewYork-Presbyterian Columbia and Cornell in New York City.
Another six received 23 out of 23 points on U.S. News’ High Performing scale: NewYork-Presbyterian, NYU Langone and Mount Sinai — all three in New York City — plus Cedars-Sinai Medical Center in Los Angeles, Northwestern Memorial Hospital in Chicago and Mayo Clinic-Arizona in Phoenix.
There is significant crossover among U.S. News’ Honor Roll 20, CMS star rankings and Forbes‘ rankings. Of the 20 hospitals recognized on U.S. News’ honor roll, 15 have five CMS stars and the remaining have four. Twelve out of 20 are Forbes five-star. The eight that missed Forbes include UCLA, UCSF in San Francisco, Cedars-Sinai, Massachusetts General Hospital in Boston, Johns Hopkins and Hospital of the University of Pennsylvania in Philadelphia.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
