Hospital Readmission Rates: Why They Matter for Your Care

Hospital readmission rates measure how often patients return to the hospital within 30 days of being discharged. High readmission rates can signal problems with the quality of care, discharge planning, or follow-up — making this an important metric for patients evaluating hospitals.

What Are Readmission Rates?

A hospital readmission occurs when a patient is admitted to any hospital within 30 days of being discharged from an initial hospitalization. CMS tracks readmission rates for several conditions and procedures:

• Heart attack (AMI)
• Heart failure
• Pneumonia
• COPD
• Stroke
• Hip/knee replacement
• CABG surgery

Why Readmission Rates Matter

Readmissions are significant for several reasons:

• Quality indicator: High readmission rates may indicate inadequate treatment during the initial stay
• Discharge planning: Poor discharge instructions or lack of follow-up care can lead to preventable readmissions
• Patient safety: Each hospital stay carries risks of infection, falls, and other complications
• Cost: Readmissions cost Medicare billions of dollars annually and create financial burden for patients
• Patient experience: Returning to the hospital disrupts recovery and affects quality of life

The Hospital Readmissions Reduction Program

Since 2012, CMS has operated the Hospital Readmissions Reduction Program (HRRP), which reduces Medicare payments to hospitals with excess readmissions. This program has motivated hospitals to:

• Improve discharge planning and patient education
• Coordinate with outpatient providers for follow-up care
• Implement medication reconciliation programs
• Create transition care programs for high-risk patients
• Develop patient follow-up call programs

How to Interpret Readmission Data

Like mortality rates, CMS compares hospitals to the national average:

• "Better than the national average": Lower readmission rates (fewer patients return)
• "No different than the national average": Readmission rates are typical
• "Worse than the national average": Higher readmission rates (more patients return)

What You Can Do

• Before discharge, make sure you understand your care instructions, medications, and warning signs to watch for
• Schedule follow-up appointments before leaving the hospital
• Ask about transition care programs if you have a chronic condition
• Know who to call if your condition worsens after discharge
• Research hospital readmission rates at Medicare Care Compare

Data sourced from CMS. Visit Medicare Care Compare or call 1-800-MEDICARE for the latest data.

Disclaimer: This article is for informational purposes only and does not constitute medical advice.