This AHRQ-funded study conducted a detailed economic analysis of acute care hospitals in 11 states and their reported quality and safety of care measures. While unlike a prior study of Florida hospitals, this study found no significant relationship between financial performance and quality of care, the authors highlight a number of important policy implications. They advocate for continued efforts to monitor the quality and safety of care delivered, particularly in hospitals with poor financial performance that are likely to opt out of voluntary reporting to avoid the costs associated with data collection. They also express concern about the impact of pay-for-performance programs that may further limit hospitals with poor financial status from making necessary improvements and investments in care.