Preferred providers: business North Carolina's best hospitals.

• Author: Martin, Cathy

The cost of hospital services has increased 33% over the last six years, federal statistics show, outpacing price hikes of insurance premiums and prescription drugs. With higher costs comes more pressure to perform, which makes Business North Carolina's annual quality rankings of the state's adult, acute-care hospitals with at least 50 beds ever more relevant. Last year's top two performers remained at the top of the charts. Duke University Hospital is part of the Durham-based health system that includes one of the nation's largest biomedical research hubs. Asheville's Mission Hospital is the flagship of the nonprofit community-health system serving the state's westernmost counties. The methodology is largely based on information provided by the U.S. Centers for Medicare & Medicaid Services, including patient-satisfaction surveys, infection rates, and readmission and death rates for common conditions and procedures. We also consider criteria from insurer Blue Cross and Blue Shield, U.S. News & World Report and The Leapfrog Group, a Washington, D.C.-based organization that grades hospitals based on patient-safety records.

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(TIE) DUKE UNIVERSITY HOSPITAL

DURHAM | BEDS: 957 | 2016 RANK: 1

In December, the Durham City Council approved a site plan for a proposed 13-story addition that would add more than 500,000 square feet and 330 beds at Duke's flagship campus. Though formal plans haven't been released, the expansion would allow Duke to maintain operations while its 40-year-old hospital is renovated. Collectively, the hospital and its affiliates, including Duke University and the School of Medicine, are the state's third-largest private employer. The medical center, which logged more than 1.1 million outpatient visits last year, employs nearly 10,000 people.

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(TIE) MISSION HOSPITAL

ASHEVILLE | BEDS: 763 | 2016 RANK: 2

Becker's Hospital Review last year listed Mission Health CEO Ron Paulus among the nation's top physician leaders based on leadership and clinical expertise. The report recognizes 110 health-system presidents and CEOs, each with a medical degree. (John McConnell, chief executive officer of Wake Forest Baptist Medical Center in Winston-Salem, was the only other N.C. executive on the list.) Construction is underway on a $400 million patient tower (rendering, right) that will replace the former St. Joseph and Memorial hospitals. Mission is the flagship of the state's sixth-largest hospital system, which includes six medical centers...