Puerto Rico and Maryland are exempt from readmission penalties, and are still covered by Medicare. Links for Puerto Rico are below. Over a million US residents go abroad for health care each year, mostly to Mexico.
Foreign hospitals and doctors have their own payment systems for their residents, but still have prices for US travelers. They are not covered by Medicare, so hospital stays abroad do not incur readmission penalties, and do not count as costs in Accountable Care Organizations. Some US and international private insurance pays for foreign care. In any case costs are often much less than in the US, and specialized hospitals can give better care. Some of the best offer luxury as well as ordinary care.
Kiplinger (2017) says the book Patients beyond Borders, and its website have reviews of hospitals. I have not seen the book, but the website shows the size of each hospital, and often the total patients treated, though not the number of times doctors do any particular procedure, nor other measures of quality. You may have to ask.
US hospitals open foreign branches with local doctors.
Medical Travel Agencies (listing does not mean recommendation, and you may find others)
NA=US Average not available to calculate percent. See link for costs abroad
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