Toproduce a meaningful ranking of US hospitals, The SafeCare Group® utilized a comprehensive framework for the 100 SafeCare Hospitals®. The distinguished medical and legal experts who designed, developed, and implemented The Deficit Reduction Act (DRA) of 2005 and The Affordable Care Act believed that a listing of high performing hospitals in the areas of low rates of infections, complications, readmissions, high patient satisfaction, andgreat value would promote strong incentives to improve health care. These metrics subsequently became part of the Centers of Medicare and Medicaid (CMS) hospitals pay-for-performance programs of HVBP, HACRP, and HRRP. The SafeCare Group® adopted these relevant metrics as its framework for the 100 SafeCare Hospitals® methodology, termed Recognizing Healthcare Excellence®, as it represented holistic, evidence-based metrics. The framework also reflect a Balanced Scorecard of low rates of infections, complications, readmissions, and high patient satisfaction and value. The 100 SafeCare Hospitals listing is truly disruptive to the healthcare status quo. Hospitals that performed poorly on these evidence-based metrics receive a financial penalty from the CMS.