In 2018, 2,573 U.S. hospitals will be penalized¹
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Medicare’s Hospital Readmissions Reduction Program (HRRP) requires CMS to penalize acute care hospitals for readmissions within 30 days of discharge for these admission types:
- Acute myocardial infarction (AMI)
- Heart failure (HF)
- Pneumonia (PN)
- Chronic obstructive pulmonary disease (COPD)
- Elective total hip arthroplasty (THA)
- Total knee arthroplasty (TKA)
- Coronary artery bypass graft (CABG) surgery
Large, safety-net hospitals, academic medical centers and non-profit hospitals are often on the penalty list.²
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89.2% Large hospitals -
84.7% Teaching hospitals -
81.7% Non-profit hospitals
84.2% of hospitals with dedicated psychiatric services are penalized for readmissions.²
For example, risk of readmission doubles in Rhode Island when mental health or substance abuse comorbidities are present.³
Mental health or substance abuse = Significantly higher potential for readmissions
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1. Schizophrenia: 21%
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2. Bipolar disorders: 15.8%
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3. Major depression: 12%
27.4% of potentially preventable readmissions in Florida are related to mental health and substance abuse.⁴
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Notes: 1 Readmission numbers and penalty information provided by CMS: https://www.cms.gov/Medicare/Medicare-Feefor-Service-Payment/AcuteInpatientPPS/Downloads/FY2018-CMS-1677-FR-Table-15.zip 2 Hospital profile data were derived from the American Hospital Association’s AHADataviewer and then matched with the CMS penalty data referenced above. 3 See section 3.9 of “Potentially Preventable Readmissions in Rhode Island” study (April 28, 2014): http://www.ohic.ri.gov/documents/RI-Potentially-Preventable-Readmissions-2014-04-28.pdf 4 Florida Medicaid Management Information System (FMMIS) Eligibility, Encounter, and Claims Information, August 2014 - July 2015, page 21: http://ahca.myflorida.com/Medicaid/Finance/data_analytics/BI/docs/Quarterly_ SMMC_Report_Spring_2017.pdf
