Readmission Rate

How It Works

Hospital readmissions are a major quality and cost concern. The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals with excess readmissions for six conditions: heart attack, heart failure, pneumonia, COPD, hip/knee replacement, and coronary artery bypass graft. Hospitals with readmission rates higher than expected (after adjusting for patient characteristics) face Medicare payment reductions of up to 3%. The national average 30-day readmission rate is approximately 15%. High readmission rates often indicate problems with discharge planning, patient education, follow-up care coordination, or premature discharge.

Related Terms

• CMS Star Rating (Hospital Overall Rating) — A 1-to-5 star rating assigned by CMS to hospitals based on quality measures — covering mortality, safety, readmissions, patient experience, and timely care.
• Mortality Rate (Hospital) — The rate of patient deaths within 30 days of hospital admission for specific conditions — risk-adjusted to account for differences in patient severity.
• Value Score — HospitalCostData's proprietary A-F grade combining price (40%), quality rating (40%), and patient outcomes (20%) — measuring whether a hospital delivers good care at a fair price.