Cardiovascular disease is an immense public health care problem, as well as devastation for the victims it affects. Heart disease kills more Americans than any other illness, and accounts for some 300,000 Medicare hospitalizations each year. A number of programs, including the federal government's National Acute Myocardial Infarction Project, have been developed to strengthen appropriate care processes to improve patient outcomes. The aim of the 100 Top Hospitals: Cardiovascular Benchmarks for Success study is to provide benchmarks as a tool for performance improvement for use by all hospitals that provide cardiac care. The benchmarks themselves demonstrate levels of performance that can be achieved and serve as a target for peer hospitals. We annually name the hospitals setting the benchmarks so that peer hospitals hoping to emulate top performance may contact the award winners to learn what they are doing differently in treatment, technique and process of delivery of care. Among our findings:

• Survival rates are markedly higher at the benchmark hospitals, particularly for patients with congestive heart failure, and those having an angioplasty or bypass surgery.
• The benchmark teaching hospitals' wage- and severity-adjusted average cost was 14% lower than their peers.
• In 1999 and 2000, benchmark community hospitals performed at least twice as many angioplasty and bypass surgeries as their peers.