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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.

Hospitals with the highest 2023 Medicare readmission rate penalty by discharges

RankDefinitive IDHospital nameCityStateMedicare FY2023 readmission rate penalty# of dischargesExplore dataset
1916HCA Florida St Lucie Hospital (FKA St Lucie Medical Center)Port St LucieFL-3.00%13,600Explore
21117Sarah Bush Lincoln Health CenterMattoonIL-3.00%6,454Explore
31724TriStar Greenview Regional HospitalBowling GreenKY-3.00%5,712Explore
41959Beth Israel Deaconess Hospital - Milton (FKA Milton Hospital)MiltonMA-3.00%5,700Explore
54597Aspirus Riverview Hospital (FKA Riverview Hospital Association)Wisconsin RapidsWI-3.00%2,517Explore
63369Bailey Medical CenterOwassoOK-3.00%2,263Explore
7764460Cape Fear Valley - Hoke HospitalRaefordNC-3.00%1,787Explore
84079Lubbock Heart & Surgical HospitalLubbockTX-3.00%1,580Explore
9553371Methodist Hospital for SurgeryAddisonTX-3.00%1,525Explore
104141Baylor Scott & White Surgical Hospital - Fort WorthFort WorthTX-3.00%1,343Explore
114532Midwest Orthopedic Specialty HospitalFranklinWI-3.00%561Explore
123891Childress Regional Medical CenterChildressTX-3.00%517Explore
133926Baylor Scott & White Medical Center - UptownDallasTX-3.00%433Explore
14184Dignity Health Arizona Specialty Hospital (FKA Arizona Orthopedic Surgical Hospital)ChandlerAZ-3.00%416Explore
153453Surgical Institute of ReadingWyomissingPA-3.00%364Explore
164027Memorial Hermann Surgical Hospital KingwoodKingwoodTX-3.00%291Explore
17576747Kings Daughters Medical Center OhioPortsmouthOH-3.00%114Explore

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.

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