Healthcare Insights
Top 20 hospitals in value-based purchasing
Value-based purchasing, established by the Center for Medicare and Medicaid (CMS), seeks to reward hospitals by redistributing Medicare payment dollars among U.S. hospitals of the highest quality and performance.
What is the Hospital Value-Based Purchasing Program?
The Hospital Value-Based Purchasing (VBP) Program is one of several value-based care programs introduced by the Affordable Care Act. Value-based care links provider reimbursement to the quality of care they provide rather than the quantity of services they provide.
The Hospital VBP Program rewards hospitals that provide high-quality care to Medicare patients. Under the programs, hospitals receive payment adjustments based on the quality of care the hospitals deliver to patients during inpatient stays.
The payments are supported through a 2% reduction of Diagnosis-Related Group funding for participating hospitals. The money that is withheld is then distributed between eligible facilities according to performance.
Hospitals may earn an increase, decrease, or no change to their Medicare reimbursements for the following fiscal year. The actual amount of incentive payments a hospital earns is also linked to the total amount available under the program.
The performance measurement domains for the 2025 Hospital VBP Program are:
- Clinical outcomes (25%)
- Safety (25%)
- Person and community engagement (25%)
- Efficient and cost reduction (25%)
Using the Definitive Healthcare HospitalView product, we have ranked the top U.S. hospitals by their 2025 revenue adjustment.
| Rank | Hospital name | State | Definitive ID | Est. FY 2025 revenue adjustment | Medicare FY 2025 VBP adjustment | Net patient revenue | Explore dataset |
|---|---|---|---|---|---|---|---|
| 1 | Mayo Clinic Hospital - Saint Marys Campus | MN | 2191 | $ 7,476,699 | 2.6% | $3,892,370,176 | Explore |
| 2 | Tisch Hospital | NY | 2843 | $ 6,752,999 | 1.4% | $8,131,192,320 | Explore |
| 3 | AdventHealth Orlando (FKA Florida Hospital Orlando) | FL | 873 | $ 4,775,176 | 1.2% | $7,153,306,624 | Explore |
| 4 | Mayo Clinic Hospital - Arizona | AZ | 178 | $ 4,490,226 | 2.6% | $2,910,685,184 | Explore |
| 5 | Stanford Hospital - 300 Pasteur Dr | CA | 588 | $ 3,842,877 | 1.2% | $7,893,382,656 | Explore |
| 6 | Hospital of the University of Pennsylvania | PA | 3571 | $ 3,250,648 | 1.7% | $3,690,950,656 | Explore |
| 7 | Evanston Hospital (AKA NorthShore Evanston Hospital) | IL | 1154 | $ 3,234,924 | 1.9% | $1,807,113,728 | Explore |
| 8 | Cedars-Sinai Medical Center | CA | 430 | $ 2,731,249 | 0.7% | $4,341,989,376 | Explore |
| 9 | Cleveland Clinic Main Campus | OH | 3120 | $ 2,562,499 | 1.1% | $7,426,526,720 | Explore |
| 10 | NewYork-Presbyterian Weill Cornell Medical Center | NY | 541974 | $ 2,478,478 | 0.5% | $ 10,091,059,200 | Explore |
| 11 | Baylor Scott & White the Heart Hospital Baylor - Plano | TX | 3901 | $ 2,371,092 | 3.0% | $571,418,880 | Explore |
| 12 | UCSF Helen Diller Medical Center | CA | 560 | $ 2,299,569 | 0.9% | $6,146,359,296 | Explore |
| 13 | Southern California Hospital at Hollywood (FKA Hollywood Community Hospital) | CA | 372 | $ 2,209,836 | 2.3% | $317,030,208 | Explore |
| 14 | St Francis Hospital & Heart Center (AKA St Francis Hospital - The Heart Center) | NY | 2830 | $ 2,209,169 | 1.1% | $913,660,416 | Explore |
| 15 | Hospital for Special Surgery | NY | 2840 | $ 2,207,660 | 2.9% | $1,303,165,568 | Explore |
| 16 | Brigham and Womens Hospital | MA | 1969 | $ 2,127,681 | 0.8% | $2,955,813,888 | Explore |
| 17 | William P Clements Jr University Hospital (FKA UT Southwestern University Hospital - St Paul) | TX | 3923 | $ 2,085,334 | 1.5% | $2,611,149,568 | Explore |
| 18 | Mayo Clinic Hospital - Florida | FL | 792 | $ 2,015,031 | 1.4% | $1,406,596,352 | Explore |
| 19 | White Plains Hospital | NY | 2925 | $ 1,866,648 | 1.5% | $1,129,032,192 | Explore |
| 20 | The University of Kansas Hospital | KS | 1631 | $ 1,814,000 | 1.0% | $2,889,708,288 | Explore |
Fig 1. Data is from the Definitive Healthcare HospitalView product. Data is sourced from the Medicare Cost Report and is updated quarterly. Data accessed October 2025.
Which hospitals had the highest positive revenue adjustment due to value-based purchasing?
The hospital with the highest positive revenue adjustment due to VBP was Mayo Clinic Hospital - Saint Mary’s Campus. This hospital had a 2.6% VBP adjustment with a revenue adjustment of $7.4 million.
The second top hospital by positive VBP revenue adjustment was Tisch Hospital. The facility had a 1.4% VBP adjustment and a revenue adjustment of $6.7 million.
In third place is AdventHealth Orlando. With a 1.2% VBP adjustment, this hospital had a revenue adjustment of $4.7 million.
What are value-based purchasing scores?
Value-based purchasing scores track hospital performance based on four quality measures: clinical outcomes, person and community engagement, safety, and efficiency and cost reduction.
These four domains are weighted evenly and make up a hospital’s Total Performance Score (TPS). While the weightings, domains, and measures can vary each year, a hospital’s TPS drives the Medicare Value Purchasing Adjustment. A positive adjustment indicates an increase in Medicare payments, whereas a negative number indicates a decrease. This payment is based on three factors:
- Achievement points: How well a hospital performs on each of the measures compared to all hospitals’ performance during the baseline period
- Improvement points: How much it has improved on each measure compared to the baseline period
- Measure/dimension score: Represents the higher of either the achievement or improvement points
Why the VBP program matters
The value-based purchasing (VBP) program matters because it fundamentally shifts how healthcare organizations are rewarded, emphasizing quality of care over quantity of services.
By linking hospital reimbursements to performance on measures like patient outcomes, safety, satisfaction, and cost efficiency, the program encourages hospitals to deliver more coordinated, patient-centered, and cost-effective care. This shift helps reduce preventable complications, readmissions, and medical errors—ultimately improving patient health while lowering overall healthcare spending.
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