The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a patient satisfaction survey run by the Centers for Medicare and Medicaid Services (CMS). Responses are collected from a random sample of adult patients between 48 hours and 6 weeks after discharge from the hospital.
What does HCAHPS measure?
HCAHPS survey questions ask for a patient’s feedback on their hospital experience, including ratings for:
- Communication with nurses
- Communication with doctors
- Responsiveness when help is required
- Pain management
- Communication about medicines
- Discharge information
- Cleanliness and quietness of a hospital environment
- Overall hospital rating
The survey results provide standardized data for hospitals to compare their results. In addition, the publicly reported scores create transparency on the patient’s perspective of their care and hospital stay.
The Definitive Healthcare HospitalView product tracks HCAHPS scores for more than 3,200 U.S. hospitals. This Healthcare Insight reviews the top U.S. hospitals by net patient revenue for facilities with the highest and lowest HCAHPS ratings based on the October 2022 Care Compare results, which reflect 2021 data.
Based on 2021 survey results, 231 hospitals had an overall 5-star rating and 94 had a 1-star rating.
Top 10 5-star HCAHPS hospitals by net patient revenue
| Rank | Definitive ID | Hospital name | Location | Net patient revenue | Number of discharges |
| 1 | 2846 | Memorial Sloan Kettering Cancer Center | New York, NY | $4,050,993,980 | 24,167 |
| 2 | 4017 | University of Texas MD Anderson Cancer Center | Houston, TX | $3,982,982,020 | 26,908 |
| 3 | 2191 | Mayo Clinic Hospital - Saint Mary’s Campus | Rochester, MN | $3,317,828,896 | 52,451 |
| 4 | 178 | Mayo Clinic Hospital – Arizona | Phoenix, AZ | $2,066,052,128 | 16,494 |
| 5 | 1978 | Dana Farber Cancer Institute | Boston, MA | $1,564,179,491 | 1,431 |
| 6 | 818 | Moffitt Cancer Center Magnolia Campus | Tampa, FL | $1,447,136,058 | 10,272 |
| 7 | 792 | Mayo Clinic Hospital – Florida | Jacksonville, FL | $986,907,022 | 16,113 |
| 8 | 5692 | Fred Hutchinson Cancer Center | Seattle, WA | $890,271,266 | 581 |
| 9 | 2768 | Roswell Park Comprehensive Cancer Center | Buffalo, NY | $661,766,067 | 4,902 |
| 10 | 437 | USC Norris Comprehensive Cancer Center | Los Angeles, CA | $356,491,377 | 1,428 |
Fig 1. Data is from the Definitive Healthcare HospitalView product and sourced from 2021 HCAHPS results published by CMS. Accessed November 2022.
What are the largest hospitals with the highest HCAHPS scores?
Among hospitals with the highest HCAHPS ratings, Memorial Sloan Kettering Cancer Center and University of Texas MD Anderson Cancer Center have the top net patient revenue amounts at about $4 billion each. These hospitals are also some of the largest in the country by net patient revenue.
Seven of the hospitals are cancer centers. The specialized and personalized care provided by cancer centers could result in positive patient survey results. Mayo Clinic has three hospitals on the list, showcasing their successful patient care stories.
Net patient revenue for these 5-star hospitals averages $1.9 billion. Two of the top hospitals are in New York, and two are in Florida.. They average about 15,500 discharges a year.
Top 10 1-star HCAHPS hospitals by net patient revenue
| Rank | Definitive ID | Hospital name | Location | Net patient revenue | Number of discharges |
| 1 | 2803 | Maimonides Medical Center | Brooklyn, NY | $952,274,061 | 32,048 |
| 2 | 2586 | Sunrise Hospital & Medical Center | Las Vegas, NV | $799,753,918 | 36,907 |
| 3 | 2757 | BronxCare Hospital Center - Fulton Campus | Bronx, NY | $760,745,620 | 23,081 |
| 4 | 2799 | Brookdale University Hospital Medical Center | Brooklyn, NY | $627,967,105 | 21,788 |
| 5 | 890 | HCA Florida JFK Hospital | Atlantis, FL | $607,125,775 | 28,728 |
| 6 | 852 | HCA Florida Kendall Hospital | Miami, FL | $553,414,945 | 21,190 |
| 7 | 2881 | Jamaica Hospital Medical Center | Jamaica, NY | $486,656,222 | 13,640 |
| 8 | 875 | HCA Florida Osceola Hospital | Kissimmee, FL | $473,776,095 | 18,902 |
| 9 | 877 | Delray Medical Center | Delray Beach, FL | $454,996,575 | 19,531 |
| 10 | 2834 | NuHealth - Nassau University Medical Center | East Meadow, NY | $416,791,836 | 15,725 |
Fig 2. Data is from the Definitive Healthcare HospitalView product and sourced from 2021 HCAHPS results published by CMS. Accessed November 2022.
What are the largest hospitals with the lowest HCAHPS scores?
Of the hospitals that have 1-star HCAHPS ratings from 2021, Maimonides Medical Center has the highest net patient revenue followed by Sunrise Hospital & Medical Center in Las Vegas, Nevada.
Half of the hospitals on the list are in New York, and an additional four are in Florida.
The average net patient revenue for these hospitals is $613 million, and they each have an average of about 23,000 discharges a year. Compared to the largest 5-star hospitals that have an average of about 15,500 discharges, the largest 1-star hospitals tend to have a higher patient base, which may account for a lower score.
Low scores can be due to a number of factors and may be a result of higher patient-to-provider ratios, busy patient-care settings, or staffing shortages.
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