Readmission Rates in Hospitals

The Hospital Readmission Reduction Program was set up by the Centers for Medicare and Medicaid Services (CMS). For the following six conditions, this program seeks to lower 30-day readmissions:

  • Heart attack or acute myocardial infarction (AMI)
  • Pulmonary illness with chronic obstruction (COPD)
  • Heart attackd
  • Pneumonia
  • Surgery, including a coronary artery bypass graft
  • Total knee replacement or total hip replacement

The goal of this program for value-based care reimbursement is to enhance care coordination and establish a direct link between payment and the standard of patient care that the hospital offers. All hospitals strive to offer the best care possible while minimizing complications. Critical access hospitals (CAHs) are excluded from high readmission rate reimbursement penalties but must report readmission rates to CMS and track rates as a gauge of hospital performance. CAHs offer important healthcare to rural populations that might not otherwise have access to it.

Which critical access hospitals have the most readmissions for all reasons?

With a 16.80% all-cause readmission rate, St. Joseph's Hospital in Buckhannon, West Virginia, has the highest percentage among CAHs. Readmission rates at Towner County Medical Center and Wills Memorial Hospital are 16.70%. Texas is home to four of the CAHs on the list. Hospitals with higher total discharge rates might report higher readmission rates. Each patient discharge carries a 30-day readmission risk. The number of discharges and the readmission rate are not correlated, which is interesting. For instance, a few of the top 25 CAHs report total discharges of over 1,000 and have readmission rates comparable to those of hospitals with roughly 200 discharges.

What is the typical readmission rate across the entire hospital?

The nationwide average readmission rate for hospitals in the United States is 15.50%. Based on readmission information from 4,100 hospitals monitored by the HospitalView software from Definitive Healthcare. From 11.50% to 21.20% are the rates. All-cause readmission rates have slightly decreased as of late, on average. The average all-cause readmission rate at U.S. hospitals was 15.59% compared to a prior examination of this data conducted in September 2020.

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