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
- 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
|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|
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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