Healthcare has become a harder sell in many large US cities. Costs keep rising, getting an appointment takes longer than it used to, and the experience can vary widely depending on where someone lives. For people who rely on the system every day, those gaps show up fast.
The pressure lands on residents first, but employers feel it too, as do local and state officials who deal with the fallout when care falls short.
The cities highlighted below stand out for simple reasons. Care tends to stay more accessible, hospitals rate better on quality, and the systems behind them show signs of financial stability. Taken together, those factors make a real difference in how dependable healthcare feels on the ground, not just on paper.
| City | Score | Access Performance | Quality Indicators |
| Boston, MA | 78.13 | High physician availability, strong mental health support; lowest uninsured rate | Cardiovascular death rates well below national averages; strong hospital ratings; high life expectancy |
| Minneapolis–St. Paul, MN | 68.77 | Strong primary care access, high preventive service use, and high patient satisfaction | Strong outcomes across major hospitals; consistent preventive engagement |
| Philadelphia, PA | 61.19 | Strong nurse-to-patient ratios; broad preventive service access | Strong specialty and high-acuity capacity; expanding research and clinical programs |
| Seattle, WA | 59.73 | High preventive care use, leading to dental utilization | Highest quality score; high patient satisfaction; low cardiovascular mortality |
| San Diego, CA | 58.38 | Strong hospital bed availability, strong preventive care participation, and high life expectancy | Strong specialty care performance; high-quality outcomes across regional systems |
1. Boston, Massachusetts
Boston secures the strongest overall performance among major metros with a score of 78.13, supported by impressive access indicators and consistently strong clinical outcomes.
Physician availability remains among the highest in the nation, and mental health support ranks at the top.
A very low uninsured rate strengthens access across all demographic groups.
Dental and preventive care usage remains high, and cardiovascular performance surpasses national averages.
Additional context on Boston’s system reveals several standout data points that contribute to its leading position:
- Uninsured rate ranks lowest among major U.S. metros
- Adult dental visit frequency exceeds national benchmarks
- Cardiovascular death rates fall well below national averages
Hospital excellence reinforces the city’s leadership. Massachusetts General Hospital generated about $4.1 billion in net patient revenue in 2022 and maintains a top quality rating.
Brigham and Women’s Hospital holds the same distinction and remains a major hub for specialty care.
Boston Children’s Hospital produces around $2 billion in revenue and remains a national leader in pediatric services.
Dana-Farber Cancer Institute brings in more than $2 billion and continues to advance oncology care at scale.
Life expectancy reaches some of the highest levels recorded in the country.
Strong prenatal care, along with academic partnerships centered around Harvard Medical School, drives continued investment in innovation, workforce development, and advanced treatment programs.
2. Minneapolis-St. Paul, Minnesota
Minneapolis-St. Paul earns a score of 68.77 and demonstrates exceptional affordability, making it one of the most financially accessible metros for residents seeking consistent healthcare.
Emergency care pricing remains the lowest among comparable cities.
Access indicators remain strong, and patient satisfaction rates rise above national averages due to reliable primary care availability and responsive hospital systems.
More detail on cost-related advantages helps illustrate the region’s appeal to residents seeking predictable expenses:
- ER visit pricing ranks lowest among major metros
- Insurance premiums remain comparatively modest
- Procedure costs fall below national averages for several high-volume services
Buffalo Hospital receives top performance ratings driven by strong outcomes.
Abbott Northwestern Hospital increases regional capacity by supporting a large share of specialty procedures and chronic care management.
Preventive care usage rises significantly above national benchmarks.
Consistent insurance coverage and manageable pricing contribute to a stable system where residents engage in screenings and routine care more frequently than in many other metros.
3. Philadelphia, Pennsylvania
Philadelphia achieves a metro score of 61.19 and performs strongly in workforce capacity and preventive service accessibility.
Nurse-to-patient ratios outperform those found in most major cities, supported by a large healthcare labor pool and a dense network of academic training programs.
Preventive care services remain widely accessible across neighborhoods, encouraging early intervention and ongoing disease management.
Several metrics show the scale and strength of Philadelphia’s hospital systems:
- The Hospital of the University of Pennsylvania generates about $3.7 billion in NPR
- The Children’s Hospital of Philadelphia produces roughly $3.1 billion
- Temple University Hospital and Thomas Jefferson University Hospital each exceed $2 billion.
Research activity, specialty care resources, and clinical training programs continue to expand, reinforcing Philadelphia’s role as a major medical hub.
Providers in the region can also enhance oncology-related knowledge and skills through targeted continuing education and conference resources available at bioascend.com.
Strong capacity across high-acuity services contributes to consistent rankings in quality and access.
Strong capacity across high-acuity services contributes to consistent rankings in quality and access.
4. Seattle, Washington
Seattle receives a total score of 59.73 and records the highest quality score at 28.56 out of 30.
Dental care usage surpasses every other major metro, reflecting strong preventive engagement among residents.
During active phases of the COVID-19 pandemic, exposure indicators remained among the lowest nationally, partly due to early adoption of mitigation strategies and strong public health coordination.
Performance indicators of Seattle’s strength in preventive care and patient outcomes are:
- Dental service utilization ranks first among major metros
- COVID-19 local risk recorded the lowest exposure levels at critical periods
- Satisfaction ratings across hospital systems remain consistently high
University of Washington Medical Center is the anchor institution, recognized for extensive specialty programs and advanced research.
Virginia Mason Medical Center adds strong performance metrics, including patient satisfaction results that exceed national averages.
Cardiovascular mortality rates remain well below national figures. Preventive care utilization rises particularly among older adults, reinforcing Seattle’s strong quality scores.
5. San Diego, California
San Diego ranks fifth overall but secures one of the strongest quality scores in the country at 58.38.
Access indicators remain strong due to favorable hospital bed availability relative to population size.
Life expectancy sits among the highest nationwide, supported by broad preventive care engagement and a diverse range of specialty services.
Several data points reveal why San Diego continues to perform well in access and quality:
- Hospital bed availability per 1,000 residents ranks among the highest
- Life expectancy exceeds most large metros
- Access metrics outperform those recorded in nearby California regions
UC San Diego Health System anchors academic and tertiary-care services with extensive clinical and research programs.
Scripps Memorial Hospital strengthens regional specialty offerings, especially in cardiac care and oncology, and provides capacity for high-acuity treatment.
Affordability compares favorably with Los Angeles and San Francisco, giving residents access to high-quality care without the extreme cost burdens associated with some other California metros.
Specialty services maintain strong reputations for innovation and reliable outcomes.
Summary
Cities that appear at the top of multiple evaluations show a pattern of strong affordability, extensive access to providers, high-performing hospitals, and deep clinical capacity.
Patients benefit from consistent preventive care, reliable specialty services, and strong community health indicators.
Providers and policymakers can leverage these findings to guide investment priorities, while individuals weighing relocation may find these metros offer dependable care across a wide range of needs.
