Critical access hospitals with the highest readmission rates

The Centers for Medicare and Medicaid Services (CMS) created the Hospital Readmissions Reduction Program (HRRP) in 2012. The goal of this program is to reduce 30-day readmissions for the following six conditions:

Acute Myocardial Infarction (AMI) or heart attack
Chronic obstructive pulmonary disease (COPD)
Heart failure
Pneumonia
Coronary artery bypass graft (CABG) surgery
Total hip arthroplasty and/or total knee arthroplasty

This value-based care reimbursement program is designed to improve care coordination and link payment to the quality of care the hospital provides to patients. Providing the highest level of care and reducing complications are goals of all hospitals.

Critical access hospitals (CAHs), which provide essential care to rural populations that might not otherwise have healthcare access, are exempt from high readmission rate reimbursement penalties but still report readmission rates to CMS and track rates as a measure of hospital performance.

We reviewed the all-cause readmission rates for 910 CAHs tracked in the Definitive Healthcare HospitalView product. Here are the top 25 critical access hospitals by all-cause hospital-wide readmission rate.

Top 25 CAHs by all-cause hospital-wide readmission rate

Rank	Definitive ID	Hospital Name	Location	Number of staffed beds	Number of discharges	All cause hospital-wide readmission rate
1	4467	St Joseph's Hospital	Buckhannon, WV	25	859	16.80%
2	6311	Towner County Medical Center	Cando, ND	20	149	16.70%
3	1069	Wills Memorial Hospital	Washington, GA	25	291	16.70%
4	3908	Coon Memorial Hospital	Dalhart, TX	21	601	16.60%
5	2606	Desert View Hospital	Pahrump, NV	25	1,277	16.60%
6	4559	Richland Hospital	Richland Center, WI	25	840	16.50%
7	3878	Memorial Medical Center	Port Lavaca, TX	25	688	16.40%
8	2728	Mimbres Memorial Hospital	Deming, NM	25	1,091	16.40%
9	1592	Neosho Memorial Regional Medical Center	Chanute, KS	21	1,352	16.40%
10	5407	North Caddo Medical Center	Vivian, LA	25	598	16.40%
11	1477	Burgess Health Center	Onawa, IA	25	418	16.30%
12	3892	Coleman County Medical Center	Coleman, TX	25	446	16.30%
13	1598	Phillips County Hospital	Phillipsburg, KS	25	220	16.30%
14	463	Tahoe Forest Hospital	Truckee, CA	25	1,464	16.30%
15	2944	Cape Fear Valley - Bladen County Hospital	Elizabethtown, NC	25	559	16.20%
16	1268	Horizon Health	Paris, IL	25	518	16.20%
17	2088	Marlette Regional Hospital	Marlette, MI	25	200	16.20%
18	1930	Marthas Vineyard Hospital	Oak Bluffs, MA	25	892	16.20%
19	2598	Mesa View Regional Hospital	Mesquite, NV	25	1,100	16.20%
20	1499	Myrtue Medical Center	Harlan, IA	25	525	16.20%
21	3165	OhioHealth Hardin Memorial Hospital	Kenton, OH	25	346	16.20%
22	3877	Ascension Seton Edgar B Davis	Luling, TX	23	546	16.10%
23	4422	Braxton County Memorial Hospital	Gassaway, WV	25	310	16.10%
24	1267	Carle Hoopeston Regional Health Center	Hoopeston, IL	22	305	16.10%
25	3169	Hocking Valley Community Hospital	Logan, OH	25	401	16.10%

Fig. 1 Data is from the Definitive Healthcare HospitalView product. All-cause hospital readmission rates are sourced from CMS Hospital Compare. Data accurate as of July 2022.

Which critical access hospitals have the highest all-cause readmission rates?

St. Joseph's Hospital in Buckhannon, West Virginia has the highest all-cause readmission rates among CAHs at 16.80%. Towner County Medical Center and Wills Memorial Hospital have readmission rates of 16.70%. Four of the CAHs on the list are located in Texas.

We might expect that hospitals with more total discharges to report higher readmission rates. With each patient discharge, there is a risk for 30-day readmission. Interestingly, there does not seem to be a correlation between total discharges and readmission rate.

For instance, some of the top 25 CAHs report more than 1,000 total discharges and have readmission rates similar to hospitals with about 200 discharges. Instead, these differences may be due to factors such as the case complexity or co-morbidities of recent patients receiving care at the hospital.

What is the average all-cause hospital-wide readmission rate?

The average all-cause hospital-wide readmission rate for U.S. hospitals is 15.50%. This is based on readmission data from 4,100 hospitals tracked in the Definitive Healthcare HospitalView product. Rates range from 11.50% to 21.20%.

The current average represents a slight decrease in all-cause readmission rates. Compared to a previous analysis of this data in September 2020, the average all-cause readmission rate at U.S. hospitals was 15.59%.

What are critical access hospitals?

Critical access hospitals (CAHs) are defined by the Centers for Medicare and Medicaid Services (CMS) as healthcare facilities that:

have fewer than 25 acute care inpatient beds
are located more than 35 miles from the nearest hospital (or 15 miles by mountain or secondary roads)
maintain an average length of stay of 96 hours or less
must provide 24-hour emergency care services

The Definitive Healthcare HospitalView product tracks more than 1,400 CAHs.

Because of this designation and the areas in which they are located, CAHs usually have less specialists, limited service line offerings, have less access to funding and employ fewer physicians.

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