Five hospitals in six are docked for excess readmissions

The Hospital Readmissions Reduction Program grades 2,833 hospitals on 30-day readmissions for six conditions: heart attack, heart failure, pneumonia, COPD, hip and knee replacement and bypass surgery. A ratio above 1 on any one condition cuts the hospital's Medicare payments. 83.2% of graded hospitals, 2,358 of them, are above 1 on at least one. Only 475 are clean on every condition they are graded on.

The program is graded on a curve. The median ratio on every one of the six conditions sits between 0.99 and 1.00, so close to half of hospitals land above 1 on each. Hospitals graded on more conditions take more chances to miss. Of the 647 hospitals graded on all six, 44 are clean and 17 miss on all six.

Stars do not buy immunity. 98.2% of one-star hospitals are docked. So are 70.0% of five-star hospitals. By state, among those with 30 or more graded hospitals, Oregon is lowest at 53.1% and Colorado next at 55.6%. Florida is highest at 93.9%, New Jersey 93.4% and Illinois 92.7%.

Almost every hospital you call on is losing Medicare money to readmissions right now, and the CFO can name the conditions. The performance period runs July 2021 through June 2024. If what you sell touches discharge, follow-up or the first 30 days home, the readmissions report tells you which condition to lead with at each account.

Cite this: Five hospitals in six are docked for excess readmissions, ProxiSuite (2026), based on CMS Hospital Readmissions Reduction Program and Hospital General Information, Provider Data Catalog, performance period July 2021 to June 2024. https://proxisuite.com/report/hospital-readmission-penalties.html

ProxiSuite is not endorsed by or affiliated with any government agency. Analysis based on public federal data.