More small hospitals recognized among U.S. News Best Hospitals of 2026

Plenty of high-profile health systems can be found on the U.S. News & World Report’s 2026 Best Hospitals.

However, there are a host of hospitals that probably don’t have widespread recognition outside of their own communities. More smaller hospitals earned recognition on the Best Hospitals list, and that reflects some changes in the methodology from U.S. News.

In this year’s list, U.S. News refined its analysis of risk-adjusted outcome measures to assess hospitals, says Ben Harder, chief of health analysis and managing editor at U.S. News. This year’s report focuses more on outcomes and patient experience, and less on the volume of care provided in different services.

And that has led to a shift in the demographics in this year’s rankings. More small hospitals have made it onto the list of Best Hospitals.

“There are actually twice as many hospitals that have fewer than 200 beds on that list this year than there were last year,” Harder tells Chief Healthcare Executive®.

Harder says he wasn’t too surprised to see more small hospitals in the rankings.

“We did kind of expect to see that, because, as the methodologist was describing, volume is no longer a factor whatsoever in that methodology,” he says.

Pointing to revised methodology in cardiology, Harder says the rankings offer a better look at the performance of hospitals.

In cardiology, U.S. News examined 41 outcomes, including mortality among patients with heart attacks, patients who were admitted with severe heart failure, length of stay, readmission to the hospital after surgery, and successful discharge to the home.

The outcomes account for 80% of the methodology in cardiology, with patient experience measures also factoring into the mix.

“We feel confident that with 41 different outcomes across different cohorts of patients, measuring different constructs of quality, that we have enough information about these hospitals to assess their quality, really, on outcomes and patient experience, and we don't need to rely on proxies like how many patients they treat, or do they have more heart surgeries than the next hospital,” Harder says. “So we weren't surprised to see that shift.”

“But I think it really points out that there are hospitals that may not be large, they may not have a national reputation … these hospitals may be quietly getting great outcomes for patients, and under this methodology, we're able to identify that and recognize them,” he says.

Harder also notes that physician surveys are no longer used in cardiology analysis.

Even though Harder says the U.S. News team wasn’t shocked to see an uptick in small hospitals earning spots among the best, he says it’s likely that some others may not expect to see so many smaller hospitals.

“I think there will be some clinicians and folks in the healthcare industry who may be surprised by some names on the list … ‘Oh wow, that's a hospital I'm not really familiar with, maybe I've never even heard of it — is that really a top hospital for orthopedics, or for cancer, or for cardiovascular, or one of the other services we look at?’”

“I think the reason you hear me say I'm not surprised is that my team has been studying the outcomes for these hospitals all year, and in prior years as well,” he says. “So for us … this hospital is really getting great outcomes. It may not be large, it may not be famous, but it meets the criteria and it's going to earn a ranking.”

Some large hospitals didn’t match the same high rankings as in years’ past, because the rankings don’t give as much weight to the volume of patients they see.

Areas with a high number of community hospitals that aren’t big, or aren’t necessarily major academic centers, have more representation this year.

“They get really good outcomes in everything from lower-acuity things like elective orthopedic care, to cancer surgery, to heart surgery and other types of procedural care, and stroke, and treating patients in diabetic crisis or with severe pneumonia,” Harder says.

Overall, 505 hospitals were recognized on the U.S. News 2026 Best Hospitals list.