Healthcare Insights

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 key goals of all hospitals.

Critical access hospitals (CAHs) provide essential care to rural populations that might not otherwise have healthcare access. These facilities 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 1,106 CAHs reporting readmission rates in the Definitive Healthcare HospitalView product. Keep reading to see our analysis of the top 25 critical access hospitals by all-cause hospital-wide readmission rate.

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

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Rank	Hospital name	City	State	Definitive ID	All-cause hospital readmission rate	Number of discharges	Explore dataset
1	CrossRidge Community Hospital	Wynne	AR	239	17.60%	578	Explore
2	Fulton County Hospital	Salem	AR	6180	17.50%	342	Explore
3	Orange City Area Health System (FKA Orange City Hospital)	Orange City	IA	1500	17.30%	796	Explore
4	Neosho Memorial Regional Medical Center	Chanute	KS	1592	17.30%	1,468	Explore
5	Clara Barton Medical Center (FKA Clara Barton Hospital)	Hoisington	KS	1521	17.10%	495	Explore
6	Lady of the Sea General Hospital	Cut Off	LA	1784	16.80%	362	Explore
7	Horizon Health (FKA Paris Community Hospital)	Paris	IL	1268	16.80%	692	Explore
8	Mt Edgecumbe Hospital	Sitka	AK	137	16.50%	736	Explore
9	Comanche County Medical Center	Comanche	TX	3906	16.50%	616	Explore
10	Gifford Medical Center (AKA Gifford Health Care)	Randolph	VT	4249	16.40%	978	Explore
11	Helen Newberry Joy Hospital	Newberry	MI	4950	16.40%	343	Explore
12	Union County Hospital	Anna	IL	1266	16.40%	372	Explore
13	Hamilton Memorial Hospital District	Mc Leansboro	IL	1184	16.40%	379	Explore
14	Montgomery County Memorial Hospital	Red Oak	IA	1479	16.40%	565	Explore
15	Pointe Coupee General Hospital	New Roads	LA	1801	16.40%	126	Explore
16	Casey County Hospital	Liberty	KY	1647	16.40%	259	Explore
17	Breckinridge Health (FKA Breckinridge Memorial Hospital)	Hardinsburg	KY	1642	16.30%	826	Explore
18	Republic County Hospital	Belleville	KS	1604	16.30%	572	Explore
19	Hardtner Medical Center	Olla	LA	1785	16.20%	428	Explore
20	Piggott Health System (FKA Piggott Community Hospital)	Piggott	AR	230	16.20%	811	Explore
21	Northwest Florida Community Hospital	Chipley	FL	934	16.20%	694	Explore
22	Macon County General Hospital (AKA Macon Community Hospital)	Lafayette	TN	3792	16.20%	672	Explore
23	Hill Regional Hospital	Hillsboro	TX	4040	16.20%	1,069	Explore
24	York General Hospital	York	NE	2583	16.20%	684	Explore
25	Desert View Hospital	Pahrump	NV	2606	16.20%	1,347	Explore

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 2023.

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

CrossRidge Community Hospital in Wynne, Arkansas, has the highest all-cause readmission rates among CAHs at 17.6%. In second place is Fulton County Hospital in Salem, Arkansas, with a 17.5% readmission rate. Orange City Area Health System in Orange City, Iowa, and Neosho Memorial Regional Medical Center in Chanute, Kansas, tie for third place with 17.3% readmission rates.

Arkansas, Kansas, and Louisiana are the most represented states on the list, with three of the top 25 CAHs each.

One might expect hospitals with more total discharges to report higher readmission rates, as with each patient discharge, there is a risk for 30-day readmission. However, 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. critical access hospitals is 14.96%. This is based on readmission data from 1,106 CAHs tracked in the Definitive Healthcare HospitalView product. Rates range from 13.2% to 17.6%.

The current average among CAHs is slightly lower than that of U.S. hospitals in general, which is about 15.5%. Check out our analysis of readmission rates among Diagnostic Related Groups (DRGs) for a closer look at broader hospital readmission trends.

What are critical access hospitals?

Critical access hospitals 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 1,300 active CAHs.

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

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