Each year, there are ≈200 000 cardiac arrests in hospitalized patients in the United States1 and survival rates remain very poor. Article see p 1415 In this issue of Circulation , Kolte et al2 present new findings about regional variability in resuscitation rates and outcomes across the United States. The authors reviewed records of >800 000 in-hospital cardiac arrest (IHCA) events from 2003 to 2011, and identified that cardiac arrest in hospitalized patients was common with an incidence of 2.85/1000 admissions. Most notably, they reported significant variability in IHCA across states with a nearly 6-fold difference in incidence and 2-fold difference in outcomes. With this substantial variance across states, it is likely that the differences within states are even greater. These findings are disturbing and clearly signal that where you live and where you arrest matter. As with any good study, this work raises more questions than it answers. Namely, what are the factors driving this variability and how can we narrow the gap between which hospitalized patients live and which die? Ultimately, this information is critically important to patients for making informed decisions about the locations where they receive health care. First, this variability could be driven by differences in hospital capabilities. Clearly hospitals vary in the services they provide, areas of excellence, and approach to the management of critically ill patients. Differences across hospitals could relate to structural variables (eg, size, staffing ratios, teaching status) and process variables (eg, targeted temperature management, emergency cardiopulmonary bypass). Comprehensive strategies for cardiac arrest management at resuscitation-specific centers may also apply bundles of care that could collectively rather than individually impact …