Popescu I, et al. - Given that variations in hospital proximity and nongeographic factors influence differences in hospital quality for heart disease, but their relative contributions remain hidden, therefore, researchers quantified the impacts of these factors on the white-black gap in high- and low-quality hospital use for acute myocardial infarction (AMI) and coronary artery bypass grafting (CABG) surgery. They selected fee-for-service Medicare beneficiaries, aged 65 and older, from Medicare claims. These beneficiaries got hospitalized during 2009–2011 with AMI (n = 384,443) and CABG (n = 71,411). They utilized publicly accessible AMI mortality rates in order to measure hospital quality. Findings revealed that white-black variations in high-quality hospital use were significant for CABG and associated with nongeographic factors. As revealed in regional analyses, higher rates of high-quality hospital use in the Northeast (CABG) and South (AMI and CABG) were reported among white beneficiaries, whereas black demonstrated higher rates of high-quality hospital use in the Midwest (AMI). Interventions should consider health system and contextual causes for these differences.