Cardiovascular disease kills more Americans than any other illness and accounts for some 300,000 Medicare hospitalizations every year.

The federal government has taken measures to help solve what is a serious national problem. The National Acute Myocardial Infarction Project was launched to strengthen appropriate care processes to improve patient outcomes. Accordingly, in 1992, the Health Care Financing Administration (HCFA) initiated the Cooperative Cardiovascular Project to improve the quality of care for Medicare heart disease patients, and data from the Project have suggested there is ample room for improvement.

The aim of this study is to guide that improvement for the care of all cardiovascular patients. Although we limited our study to a fraction of hospitals (707) that perform certain cardiovascular procedures a defined number of times, our findings have implications that reach far beyond this subset. The benchmarks established by this study are intended to serve as a model for improvement for all hospitals that provide cardiac care.

We found that benchmark cardiac hospitals have shorter lengths of stay and lower costs while achieving superior clinical outcomes. Compared with their peers, 100 Top Cardiovascular Hospitals:

• have better better clinical outcomes in terms of mortality and complications;
• have lower costs;
• maintain shorter lengths of stay;
• appear to be technologically and clinically advanced in terms of the usage of stents and internal mammary artery grafts.