Methodology for Premier’s 100 Top Hospitals 2025

Premier’s 100 Top Hospitals Methodology Overview

To conduct Premier’s 100 Top Hospitals study, researchers evaluated 2,599 short-term, acute care, non-federal U.S. hospitals. All research was based on the following public data sets: Medicare cost reports, Medicare Provider Analysis and Review (MEDPAR) data, and measure data from the Centers for Medicare & Medicaid Services (CMS) Care Compare website. Premier selects the annual 100 Top Hospitals award winners (benchmark hospitals) using their objective methodology based on publicly available data and a balanced scorecard of performance measures, using the most current data available. Hospitals do not apply for awards, and winners do not pay to market this honor. For more information, visit http://www.100tophospitals.com/

Premier’s 100 Top Hospitals 2025: Teaching Hospitals

Premier’s 100 Top Hospitals 2025: Community Hospitals

Class definition
Each hospital is defined within a class based on their bed size and teaching status.
Major Teaching – 223 Hospitals
Teaching – 394 Hospitals
Large Community – 394 Hospitals
Medium Community – 800 Hospitals
Small Community – 800 Hospitals

Final rank
Final Rank is determined based on performance for all individual measures. Hospitals are ranked within their Class definition group.

Premier’s 100 Top Hospitals Everest Award Winner Methodology

Premier’s 100 Top Hospitals Everest Award honors hospitals that have both the highest current performance and the fastest long-term improvement in the 5 years of trend data analyzed.

The methodology for selecting the Everest Award winners can be summarized in three main steps:

1. Selecting the annual 100 Top Hospitals award winners.

2. Using Premier’s five-year trending methodology to select the 100 hospitals that have shown the fastest, most consistent improvement rates on the same balanced scorecard of performance measures.

3. Identifying those hospitals that ranked in the top 100 on both lists: These hospitals are the Premier’s 100 Top Hospitals Everest Award winners.

Methodology Changes

Premier’s 100 Top Hospitals 2025 study had a few changes made to the methodology. As a process for improvement the Teaching Hospital comparison group was updated to reflect a higher level of teaching intensity.  This change moved some hospitals previously in the teaching group to the community hospital groups.  Minor adjustments to the bed count criteria in the Large and Medium Community Hospitals groups also took place.

The winner distribution for the Major Teaching and Teaching Hospitals was also modified to reflect the shift in the number of hospitals in both groups.

In addition, due to the unavailability of the CMS Care Compare dataset that was expected in January, the Medicare Spend per Beneficiary measure was removed from the ranked metrics this year. 

Other study changes include the removal of the Health Equity Award. Premier’s 100 Top Hospitals program is in the process of developing a more formalized Health Equity study that will provide a broader and more detailed assessment of hospitals performance that are impacted most by social drivers of health.

The Community Health Measure that has been produced for the last three years was dropped due to the low receipt of responses from hospitals that were asked to complete the survey.  

Hospital measure domains

Clinical outcomes
There are five clinical measures used in the scorecard. Measures include (1) risk-adjusted IP mortality, (2) risk-adjusted complications, (3) healthcare associated infections*, (4) 30-day mortality and (5) 30-day readmissions. *Healthcare associated infections are excluded for the Small Community Hospitals peer group.

Operational efficiency
There are two operational efficiency measures used in the scorecard: (1) severity adjusted length of stay and (2) adjusted inpatient expense per discharge.

Patient experience
The patient experience measure reflects the overall patient rating from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey tool.

Financial health
The financial health measure used in the scorecard is adjusted operating profit margin. 

Stars key:

  • 5 stars (★★★★★) = Hospital performing at top quintile (>80-100%) within their peer group
  • 4 stars (★★★★) = Hospital performing within second quintile (>60-80%) within their peer group
  • 3 stars (★★★) = Hospital performing within third quintile (>40-60%) within their peer group
  • 2 stars (★★) = Hospital performing within fourth quintile (>20-40%) within their peer group
  • 1 star (★) = Hospital performing in the bottom quintile (0-20%) within their peer group

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