Hospital readmission penalties seem to have been working as intended, by driving down 30-
day hospital readmissions and saving Medicare roughly $2.3 billion between 2010 and
2016. The unintended consequence, however, was that hospitals serving the poorest of
the poor were the most frequently penalized. Medicare has made changes to mitigate
that, but safety-net hospitals still struggle with reducing hospital readmissions largely attributable to social determinants of care, and they still risk penalties that could push them over the fiscal
edge.
