Top 10 States Penalized for Readmissions in 2016

Which states got hit with the highest penalties in 2016 for their hospital readmission rates?

In this week’s blog, we feature a slideshow of the top 10 states who had the highest total dollar amounts stripped from their hospitals under the Hospital Readmission Reduction Program (HRRP).

Source: Jim Hoffman, COO, BESLER Consulting.

HRRP is a section of the Affordable Care Act requiring CMS to penalize hospitals that continue to have excessive readmission rates. This includes readmissions for any reason (excluding planned visits) within 30 days to any hospital following the initial entrance. While all readmission rates are considered, penalties were only assessed for readmissions of patients with acute myocardial infarction (AMI), heart failure, pneumonia, chronic obstructive pulmonary disease (COPD) and total hip or knee replacement.

Hospital penalties began in 2013, but were only considered for heart attack, heart failure, or pneumonia. In later years, COPD and total hip or knee replacement were considered. Starting this year, coronary artery bypass graft (CAPG) will also be considered.

The amount of money collected in penalties has also increased since 2013.

• 2013: $290 million in total penalties
• 2014: $227 million in total penalties
• 2015: $428 million in total penalties
• 2016: $420 million in total penalties

In 2017, CMS estimates that the number of penalty dollars will jump up to $528 million.

On-Demand Webinar:


Reducing readmission rates is a top priority for many hospitals, especially those who have been penalized through the CMS Hospital Readmission Reduction Program (HRRP).

In this video you will learn about:

  • Your at-risk FFS Revenue:
    The genesis of readmission penalties and what you can do today to prevent future penalties.
  • Lessons learned:
    How one hospital used predictive analytics to alert staff and substantially impact patient health through reduced readmissions.
  • A predictive analytics solution:
    How to create and use accurate, predictive risk reporting using RAPID.

Watch Now

Erin Heilman