Which state has the best hospital quality?

Utah has the highest average CMS hospital overall star rating at 4.24 stars, with 79% of its 29 rated hospitals at 4 or 5 stars. Puerto Rico has the lowest average at 1.71 stars.

What share of US hospitals have a 5-star CMS rating?

Of the 3,182 Medicare-certified hospitals with a CMS overall star rating, 384 (12.1%) earn the top 5-star rating, while 199 (6.3%) carry the lowest 1-star rating. The national average overall rating is 3.21 stars.

DATA STUDY · 2025 EDITION

Best & Worst States for Hospital Quality

Q: What does the CMS hospital overall star rating mean?

CMS assigns each eligible hospital an overall star rating from 1 (lowest) to 5 (highest) stars, summarizing measures across mortality, safety of care, readmissions, patient experience, and timely & effective care. The rating is published on CMS Care Compare and updated periodically.

Utah hospitals earn the highest average CMS star rating — and Puerto Rico the lowest. We analyzed the CMS overall star rating for 3,182 Medicare-certified hospitals to rank every state on hospital quality, map the national 1-star vs 5-star split, and show where care rates best and worst. Updated annually against the latest CMS Care Compare release.

12.1%

RATED 5 STARS

6.3%

RATED 1 STAR

3.21

AVG OVERALL RATING

3,182

HOSPITALS ANALYZED

National distribution

How hospitals split across the 5 stars

5 stars

384 (12.1%)

4 stars

950 (29.9%)

3 stars

987 (31.0%)

2 stars

662 (20.8%)

1 star

199 (6.3%)

States with the weakest hospital quality

Lowest average hospital rating — bottom 12 states

States ranked best → worst

Average hospital rating, by state

Mean CMS overall star rating per state, with the share of hospitals rated 4–5 stars and the share rated 1–2 stars. States with at least five rated hospitals. Tap any state to browse its hospitals.

#	State	Avg rating	% 4–5 star	% 1–2 star	Hospitals
1	Utah	4.24	79%	7%	29
2	Colorado	3.96	73%	4%	49
3	South Dakota	3.89	72%	11%	18
4	Wisconsin	3.78	64%	8%	86
5	Minnesota	3.77	63%	7%	57
6	Virginia	3.68	61%	8%	76
7	Ohio	3.58	53%	9%	128
8	Rhode Island	3.55	64%	9%	11
9	Idaho	3.55	45%	14%	22
10	Nebraska	3.50	64%	14%	36
11	Pennsylvania	3.48	56%	20%	132
12	South Carolina	3.43	49%	20%	49
13	Connecticut	3.42	46%	19%	26
14	Texas	3.38	48%	20%	217
15	Wyoming	3.38	44%	19%	16
16	Indiana	3.36	44%	19%	91
17	Maryland	3.31	38%	19%	42
18	North Carolina	3.30	44%	23%	90
19	Oklahoma	3.29	45%	26%	62
20	North Dakota	3.25	44%	25%	16
21	Oregon	3.25	45%	23%	44
22	Montana	3.25	40%	30%	20
23	Vermont	3.25	33%	17%	12
24	Iowa	3.24	45%	29%	62
25	Washington	3.23	40%	25%	60
26	Maine	3.21	42%	21%	24
27	Massachusetts	3.20	39%	31%	54
28	Hawaii	3.18	45%	27%	11
29	Kansas	3.18	42%	25%	55
30	New Hampshire	3.17	43%	22%	23
31	New Jersey	3.15	39%	28%	61
32	Delaware	3.14	29%	14%	7
33	Missouri	3.14	41%	30%	80
34	Arizona	3.11	33%	35%	55
35	California	3.10	41%	31%	280
36	Michigan	3.09	38%	30%	94
37	Tennessee	3.08	36%	28%	72
38	Florida	3.07	37%	32%	169
39	Illinois	3.03	36%	32%	136
40	Nevada	3.00	28%	40%	25
41	Georgia	2.94	32%	36%	84
42	Alaska	2.90	30%	40%	10
43	District of Columbia	2.86	14%	29%	7
44	Arkansas	2.84	25%	41%	44
45	Louisiana	2.81	22%	36%	59
46	New York	2.77	26%	49%	136
47	West Virginia	2.76	26%	47%	34
48	Kentucky	2.76	24%	43%	67
49	Alabama	2.71	19%	39%	59
50	New Mexico	2.48	17%	61%	23
51	Mississippi	2.33	13%	60%	52
52	Puerto Rico	1.71	14%	86%	7

Methodology

Figures come from the CMS Care Compare hospital dataset — the official Medicare quality program. The overall star rating runs from 1 (lowest) to 5 (highest) and summarizes measures across mortality, safety of care, readmissions, patient experience, and timely & effective care. We include every Medicare-certified hospital with a published overall rating (3,182 hospitals).

State averages cover states with at least five rated hospitals so a single facility can't swing the mean. Not every hospital is eligible for an overall rating — specialty, critical-access, and newly opened hospitals are often unrated — so state counts reflect rated hospitals only. CMS ratings lag real conditions by several months; use them alongside the specific measures behind the score.

Want the detail behind any number? Browse all hospitals, see our companion study on nursing home star ratings by state, or jump to Utah hospitals.

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This research is free to reference. Journalists and researchers are welcome to cite the figures with a link back to CareLens.

CITATION

CareLens. (2025). Best & Worst States for Hospital Quality. Retrieved from https://carelens.io/hospital-quality-by-state

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<a href="https://carelens.io/hospital-quality-by-state" style="display:inline-block;border-left:4px solid #84cc16;padding:10px 14px;font:14px/1.4 system-ui,sans-serif;color:#0f172a;text-decoration:none;background:#f8fafc;border-radius:4px;max-width:520px"><strong>Utah has the highest average CMS hospital rating (4.24★); Puerto Rico the lowest (1.71★)</strong><br>Source: CareLens — Best & Worst States for Hospital Quality (2025)</a>

PREVIEW

Utah has the highest average CMS hospital rating (4.24★); Puerto Rico the lowest (1.71★)
Source: CareLens — Best & Worst States for Hospital Quality (2025)