Healthcare Insights
Hospitals with the highest readmission penalties
The Centers for Medicare and Medicaid Services’ (CMS) Hospital Readmission Reduction Program (HRRP) establishes reimbursement penalties for hospitals with excessive preventable readmissions.
The program aims to incentivize facilities to improve communication and care coordination in post-discharge planning to avoid additional hospitalizations. Hospitals with higher readmissions compared to national averages can be docked a 1% to 3% penalty on reimbursement from CMS.
The Definitive Healthcare HospitalView product tracks hospital readmission penalties and the estimated revenue loss for nearly 3,000 U.S. hospitals. The table below features the largest hospitals with the highest readmission rate penalty in 2023, the last full year for which readmission penalty data is available.
| Rank | Definitive ID | Hospital name | City | State | Medicare FY2023 readmission rate penalty | # of discharges | Explore dataset |
|---|---|---|---|---|---|---|---|
| 1 | 916 | HCA Florida St Lucie Hospital (FKA St Lucie Medical Center) | Port St Lucie | FL | -3.00% | 13,600 | Explore |
| 2 | 1117 | Sarah Bush Lincoln Health Center | Mattoon | IL | -3.00% | 6,454 | Explore |
| 3 | 1724 | TriStar Greenview Regional Hospital | Bowling Green | KY | -3.00% | 5,712 | Explore |
| 4 | 1959 | Beth Israel Deaconess Hospital - Milton (FKA Milton Hospital) | Milton | MA | -3.00% | 5,700 | Explore |
| 5 | 4597 | Aspirus Riverview Hospital (FKA Riverview Hospital Association) | Wisconsin Rapids | WI | -3.00% | 2,517 | Explore |
| 6 | 3369 | Bailey Medical Center | Owasso | OK | -3.00% | 2,263 | Explore |
| 7 | 764460 | Cape Fear Valley - Hoke Hospital | Raeford | NC | -3.00% | 1,787 | Explore |
| 8 | 4079 | Lubbock Heart & Surgical Hospital | Lubbock | TX | -3.00% | 1,580 | Explore |
| 9 | 553371 | Methodist Hospital for Surgery | Addison | TX | -3.00% | 1,525 | Explore |
| 10 | 4141 | Baylor Scott & White Surgical Hospital - Fort Worth | Fort Worth | TX | -3.00% | 1,343 | Explore |
| 11 | 4532 | Midwest Orthopedic Specialty Hospital | Franklin | WI | -3.00% | 561 | Explore |
| 12 | 3891 | Childress Regional Medical Center | Childress | TX | -3.00% | 517 | Explore |
| 13 | 3926 | Baylor Scott & White Medical Center - Uptown | Dallas | TX | -3.00% | 433 | Explore |
| 14 | 184 | Dignity Health Arizona Specialty Hospital (FKA Arizona Orthopedic Surgical Hospital) | Chandler | AZ | -3.00% | 416 | Explore |
| 15 | 3453 | Surgical Institute of Reading | Wyomissing | PA | -3.00% | 364 | Explore |
| 16 | 4027 | Memorial Hermann Surgical Hospital Kingwood | Kingwood | TX | -3.00% | 291 | Explore |
| 17 | 576747 | Kings Daughters Medical Center Ohio | Portsmouth | OH | -3.00% | 114 | Explore |
Fig. 1 Analysis of data from the Definitive Healthcare HospitalView product. Penalty data is sourced from results published by CMS for fiscal year 2023. Accessed December 2024.
Which hospitals have the highest readmission rate penalties?
For fiscal year 2023, 17 hospitals received the highest readmission rate penalty, indicating their Medicare revenue will decrease by 3% based on their readmission rates. Of these hospitals, HCA Florida St. Lucie Hospital is the largest based on its 13,600 annual discharges.
Seven hospitals on the list are in Texas, averaging 940 discharges a year.
Numerous factors affect a hospital’s readmission rate, and therefore their readmission penalties, including the health of the patient population and the severity of their conditions during their hospital stay.
How much do hospitals get penalized for readmissions?
On average, the 2,799 hospitals that participate in HRRP are penalized by 0.34% of their Medicare revenue.
How is the CMS readmission rate penalty calculated?
HRRP reduces payments to Inpatient Prospective Payment System (IPPS) hospitals with excess readmissions as compared to the national average for the applicable condition.
The Medicare readmission rate penalty is a ratio based on payments made for excess readmissions out of all payments for discharges. A negative ratio indicates a decrease in reimbursement by that percentage amount, up to 3%.
What is a hospital readmission?
Readmissions are defined as admissions to an acute care hospital within 30 days of discharge to any subsection (i.e. department) of that entity for any condition or diagnosis.
Learn more
Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians, and other healthcare providers.
You might also be interested in...
