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 2021.

Top hospitals with highest 2021 Medicare readmission rate penalty by discharges

RankDefinitive IDHospital nameLocation2021 Medicare readmission rate penaltyNumber of dischargesExplore dataset
14029CHRISTUS Good Shepherd Medical Center - MarshallMarshall, TX-3.00%16,878Explore
2309Oroville HospitalOroville, CA-3.00%12,899Explore
3916HCA Florida St Lucie Hospital (FKA St Lucie Medical Center)Port St Lucie, FL-3.00%12,064Explore
4235NEA Baptist Memorial HospitalJonesboro, AR-3.00%10,840Explore
51964Beth Israel Deaconess Hospital - PlymouthPlymouth, MA-3.00%10,546Explore
61928Saint Annes HospitalFall River, MA-3.00%9,138Explore
7618Emanuel Medical CenterTurlock, CA-3.00%9,048Explore
81711Hazard ARH Regional Medical CenterHazard, KY-3.00%7,584Explore
91929Sturdy Memorial HospitalAttleboro, MA-3.00%7,066Explore
101117Sarah Bush Lincoln Health CenterMattoon, IL-3.00%6,442Explore
111959Beth Israel Deaconess Hospital - Milton (FKA Milton Hospital)Milton, MA-3.00%5,867Explore
121630Providence Medical CenterKansas City, KS-3.00%5,694Explore
131724TriStar Greenview Regional HospitalBowling Green, KY-3.00%5,320Explore
143622East Cooper Medical CenterMount Pleasant, SC-3.00%5,038Explore
151933Anna Jaques HospitalNewburyport, MA-3.00%4,768Explore
16901HCA Florida Pasadena Hospital (FKA Palms of Pasadena Hospital)St Petersburg, FL-3.00%4,514Explore
17550094Hackensack Meridian Health Pascack Valley Medical CenterWestwood, NJ-3.00%4,386Explore
181690Whitesburg ARH HospitalWhitesburg, KY-3.00%3,231Explore
192383St Marys Medical CenterBlue Springs, MO-3.00%3,098Explore
201673Harlan ARH HospitalHarlan, KY-3.00%2,881Explore
213895Baylor Scott & White Medical Center - FriscoFrisco, TX-3.00%2,849Explore
221324Henry Community HealthNew Castle, IN-3.00%2,437Explore
231712Tug Valley ARH Regional Medical Center (FKA Williamson ARH Hospital)South Williamson, KY-3.00%1,912Explore
243455Conemaugh Health System - Conemaugh Nason Medical Center (FKA Nason Hospital)Roaring Spring, PA-3.00%1,682Explore
251776Our Lady of Lourdes Heart Hospital (FKA Heart Hospital of Lafayette)Lafayette, LA-3.00%1,621Explore
261015Perry HospitalPerry, GA-3.00%1,350Explore
274141Baylor Scott & White Surgical Hospital - Fort WorthFort Worth, TX-3.00%1,293Explore
283530Lehigh Valley Health Network - 1503 N Cedar Crest (FKA Coordinated Health - Allentown Hospital)Allentown, PA-3.00%1,095Explore
292073Trinity Health Grand Haven (FKA North Ottawa Community Hospital)Grand Haven, MI-3.00%1,055Explore
30599Sutter Maternity & Surgery Center of Santa CruzSanta Cruz, CA-3.00%996Explore
31550790WellSpan Surgery & Rehabilitation HospitalYork, PA-3.00%725Explore
323926Baylor Scott & White Medical Center - UptownDallas, TX-3.00%606Explore
333160TriHealth Evendale Hospital (AKA Good Samaritan Hospital at Evendale)Cincinnati, OH-3.00%498Explore
343453Surgical Institute of ReadingWyomissing, PA-3.00%470Explore
354028Houston Physicians HospitalWebster, TX-3.00%413Explore
364027Memorial Hermann Surgical Hospital KingwoodKingwood, TX-3.00%342Explore
373269Oklahoma Center for Orthopaedic & Multi-Specialty SurgeryOklahoma City, OK-3.00%307Explore
383966Memorial Hermann Surgical Hospital First Colony (FKA Sugar Land Surgical Hospital)Sugar Land, TX-3.00%218Explore
391996Spectrum Health Lakeland Watervliet HospitalWatervliet, MI-3.00%35Explore

Fig. 1. Data is from the Definitive Healthcare HospitalView product and sourced from results published by CMS. Accessed December 2022

Which hospitals have the highest readmission rate penalties?

For fiscal year 2021, 39 hospitals received the highest readmission rate penalty – their Medicare revenue will decrease by 3% based on their readmission rates. Of these hospitals, CHRISTUS Good Shepherd Medical Center – Marshall, is the largest based on its nearly 17,000 annual discharges.

Seven hospitals on the list are in Texas and five are in both Massachusetts and Kentucky. They average 4,287 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 2,985 hospitals that participate in HRRP are penalized by 0.59% of their Medicare revenue, or about a $178,000 loss each in 2021.

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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