Healthcare Insights
Critical Access Hospitals with the Highest Readmission Rates
Critical access hospitals (CAHs) provide essential care to populations that might not otherwise have healthcare access. To qualify as a critical access hospital, these facilities must be located in a rural area. In rural areas, population density is lower, and the number of uninsured or underinsured patients is generally higher.
Critical access hospitals treat many low-income patients with little to no insurance coverage. Because of this, complications and high readmission rates are much more likely.
Are critical access hospitals exempt from the readmission reduction program?
Critical access hospitals play an important role in improving care access. Because of this, they receive certain benefits from the Centers for Medicare and Medicaid Services (CMS). As part of these benefits, CAHs are exempt from financial penalties in the Hospital Readmissions Reduction Program (HRRP).
CMS instituted the Hospital Readmissions Reduction Program in 2012. The goal of this program is to reduce excess 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
The HRRP has a strong focus on reducing 30-day readmissions for cardiovascular conditions. Three of the six conditions listed above are related to heart conditions. Cardiac readmissions are particularly relevant for critical access hospitals. According to the National Institutes of Health, poverty can increase the risk of many diseases, including:
- Heart disease
- Diabetes
- Cancer
Critical access hospitals may not face financial penalties from CMS for excess readmissions. But because of the increased risk factors that low-income patients face, many CAHs report high 30-day readmission rates.
Here are the top 25 critical access hospitals by all-cause hospital-wide readmission rate.
Top 25 critical access hospitals by all-cause hospital-wide readmission rate
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Rank | Definitive ID | Hospital Name | State | Number of Staffed Beds | Total Discharges | All-Cause Readmission Rate | Explore This Dataset |
1 | 1500 | Orange City Area Health System | IA | 25 | 816 | 17.50% | Explore This Profile |
2 | 3792 | Macon County General Hospital | TN | 25 | 783 | 17.50% | Explore This Profile |
3 | 5516 | Riverside Medical Center | LA | 25 | 319 | 17.30% | Explore This Profile |
4 | 2316 | Simpson General Hospital | MS | 25 | 304 | 17.20% | Explore This Profile |
5 | 4608 | Hot Springs County Memorial Hospital | WY | 25 | 489 | 17.10% | Explore This Profile |
6 | 3892 | Coleman County Medical Center | TX | 25 | 499 | 17.10% | Explore This Profile |
7 | 4249 | Gifford Medical Center | VT | 25 | 1,148 | 17.10% | Explore This Profile |
8 | 3672 | Huron Regional Medical Center | SD | 25 | 1,295 | 17.00% | Explore This Profile |
9 | 2538 | Avera St Anthonys Hospital | NE | 25 | 782 | 17.00% | Explore This Profile |
10 | 230 | Piggott Community Hospital | AR | 25 | 729 | 17.00% | Explore This Profile |
11 | 1185 | Hardin County General Hospital | IL | 25 | 379 | 16.90% | Explore This Profile |
12 | 3078 | Adams County Regional Medical Center | OH | 25 | 923 | 16.90% | Explore This Profile |
13 | 3260 | The Physicians Hospital In Anadarko | OK | 25 | 179 | 16.80% | Explore This Profile |
14 | 1510 | Wayne County Hospital | IA | 25 | 804 | 16.80% | Explore This Profile |
15 | 1647 | Casey County Hospital | KY | 24 | 586 | 16.80% | Explore This Profile |
16 | 1720 | The Medical Center at Franklin | KY | 25 | 539 | 16.80% | Explore This Profile |
17 | 6180 | Fulton County Hospital | AR | 25 | 549 | 16.80% | Explore This Profile |
18 | 1550 | Graham County Hospital | KS | 20 | 212 | 16.70% | Explore This Profile |
19 | 2404 | Perry County Memorial Hospital | MO | 25 | 1,506 | 16.70% | Explore This Profile |
20 | 4087 | Medina Regional Hospital | TX | 25 | 549 | 16.70% | Explore This Profile |
21 | 5532 | Fayette County Hospital | IL | 29 | 489 | 16.70% | Explore This Profile |
22 | 4982 | Avera Gettysburg Hospital | SD | 10 | 105 | 16.60% | Explore This Profile |
23 | 3878 | Memorial Medical Center | TX | 25 | 841 | 16.60% | Explore This Profile |
24 | 2353 | Cass Regional Medical Center | MO | 25 | 827 | 16.60% | Explore This Profile |
25 | 1517 | Allen County Regional Hospital | KS | 25 | 409 | 16.60% | Explore This Profile |
Fig. 1 Data is from Definitive Healthcare’s Hospitals & IDNs database. All-cause hospital readmission rates are sourced from the July 2020 CMS Quality Metrics Update. The next Quality Metrics Update is scheduled to be released in October 2020. Accessed September 2020.
Which critical access hospitals have the highest all-cause readmission rates?
Orange City Area Health System and Macon County General Hospital have the highest all-cause readmission rates. As of July 2020, both these CAHs reported an all-cause readmission rate of 17.5 percent. According to Definitive Healthcare data, 15.59 percent is the average all-cause readmission rate at U.S. hospitals.
We might expect that hospitals with more total discharges 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. Despite this, they have lower all-cause readmission rates than other hospitals on the list.