For the second consecutive year, more than 2000 US hospitals will be collectively penalized upward of $200 million for readmissions of Medicare patients within 30 days of discharge.1 The fines have been levied under the Medicare Hospital Readmissions Reduction Program (HRRP), which was established by the Affordable Care Act as part of a larger effort to slow the growth of health care spending while improving the quality of care. Under the HRRP, hospitals are penalized for higher-than-expected readmissions rates compared with the national average. In part because of these incentives, many health systems are reexamining their approach to prevention of early readmissions.