Hospitals with limited resources continue to struggle as they try to implement programs that drive down readmission rates, and federal penalties could potentially make matters worse, write the authors of a report published in the Joint Commission's Journal on Quality and Patient Safety.
Socio-economic factors such as homelessness and lack of transportation were commonly cited in interviews the researchers conducted with executives and frontline staff at eight U.S. safety net hospitals.
In a recent blog post, one of the study authors said he has changed his mind about whether adjustments for socio-economic factors should be considered in the federal hospital readmissions reductions program. “I used to be against it,” Dr. Ashish Jha, director of the Harvard Global Health Institute, wrote in a Sept. 29 blog post. “But having spent more time thinking about it, it's the right thing to do under specific circumstances,” he said.
The Hospital Readmission Reduction Program, created as part of the Patient Protection and Affordable Care Act, began penalizing hospitals for having excess numbers of patients return to the hospital following treatment for heart attacks, heart failure and pneumonia in fiscal 2013. Hospitals with excess readmissions initially had their Medicare payments docked up to 2%, and the maximum penalty rises to 3% in fiscal 2015.
Although readmissions were a called high priority, few could cite actual readmission rates. 
