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.