A Designation Can Be a Good Starting Point

Many programs set rules that hospitals must meet. Those rules may cover staffing, training, case volume, data tracking, or how care is delivered.

That can matter. If you need complex care, you want the right people and systems around you.

But meeting a set of standards is not the same as getting the best results.

A 2017 JAMA Surgery study looked at 145,527 patients who had bariatric surgery for obesity at 165 Centers of Excellence. After the researchers adjusted for patient differences, serious complication rates still ranged from 0.6% to 10.3% across the centers. In other words, in once center about 1 person out of 200 would have a serious complication and in the other about 20 people would. That’s 19 more people out of 200 and yet both programs were considered “Centers of Excellence.”

An earlier JAMA study looked at a Medicare rule that required bariatric surgery to be done at a designated Center of Excellence. Results improved over time. But they were already improving before the rule began.

After researchers took those earlier trends into account, the rule itself was not linked to a clear added drop in complications or repeat operations. The researchers also compared 179 designated centers with 519 hospitals without the designation. They found no clear difference in the study’s three main results.

These studies were about bariatric surgery and specific programs. They do not show that accreditation never matters. They show why a label should not be the only thing you use to choose care.

The Doctor Inside the Center Matters Too

A strong hospital can still have differences among its doctors.

A New England Journal of Medicine study looked at 20 bariatric surgeons. Each surgeon sent in a video of the same type of operation. At least 10 other surgeons rated each video without knowing who the surgeon was. The researchers then compared those skill ratings with results from 10,343 patients.

Patients treated by surgeons in the lowest-rated group had a 14.5% complication rate. The rate was 5.2% for patients treated by surgeons in the highest-rated group. Lower skill ratings were also linked with more repeat operations, hospital readmissions, and emergency room visits.

The ratings were not clearly tied to years in practice, fellowship training, or whether the surgeon worked at a teaching hospital.

It is important to note that the study was small and looked at only one type of surgery. Each surgeon also chose one video to submit. The authors called the findings preliminary. Even so, the study makes an important point: the hospital label does not tell you everything about the doctor who will treat you.

Not All Designations Mean the Same Thing

Some designations tell you more than others. It depends on what the program looks for.

NCI-Designated Cancer Centers are a good example. The National Cancer Institute uses detailed standards to identify centers with strong cancer research programs that bring together experts from many fields. NCIDesignated Comprehensive Cancer Centers must meet even broader research standards.

For some complex cancers, that kind of multidisciplinary expertise can matter. These centers may also offer highly specialized care and access to cancer research.

There is evidence that care at comprehensive cancer centers can be linked to better results. A 2025 review looked at 36 studies, most of them from the United States and many involving NCI-designated comprehensive centers. In the studies that could be combined, care at comprehensive cancer centers was linked with a 23% lower overall risk of death.

But there is an important limit. All 36 studies were observational. Patients were not randomly sent to one type of center or another. That means the review cannot prove that the type of center itself caused the better results.

For some conditions, a designation may point to skills and services that are hard to find elsewhere. For others, it may mainly show that a hospital met a set of standards.

Look Beyond the Label

If a hospital promotes a Center of Excellence, accreditation, or other special label, ask a few questions.

Who gave the designation? What did the hospital have to do to earn it? Is the designation tied to your condition or procedure? Does it look at patient results, or mainly at staff, equipment, and care steps? How recently was the hospital reviewed?

Then look one level deeper. How much experience does your doctor have with the care you need? How many of these cases did the surgeon perform in the last year? Does the doctor or hospital track results for that care?

You may not get a simple answer to every question. Some quality data are not public. A doctor may not have an individual report ready to share. That does not mean the care is poor.

The goal is to use a designation for what it is: one useful piece of information.

A strong designation can tell you a lot about a hospital’s ability to provide certain types of care. For some conditions, it may be an important reason to go there.

But no label can tell you everything about the doctor, the team, or the results that matter for your care.