The Centers for Medicare & Medicaid Services designed the Hospital Value-Based Purchasing (HVBP) program and the Overall Hospital Quality Star Ratings program to improve healthcare quality across the US. Controversy remains concerning whether these initiatives truly encourage institutions to continuously work to improve the quality of care provided. To address some of these knowledge gaps, we applied data from the Modern Healthcare Hospital Penalties and Rewards dataset to identify potential relationships. We found the mean HVBP adjustments differed significantly between Ohio and Washington with a mean difference of 0.10% and between Pennsylvania and Washington with 0.08%, and the mean hospital overall ratings differed significantly between Georgia and Ohio with a mean a difference of 0.58 and between Ohio and Washington 0.65. Therefore, by evaluating the potential relationships, we can interpret the impact of geographic region on Medicare rewards and penalties, healthcare quality, and thus the impact on patient care.