To address concerns that Medicare’s Hospital Readmissions Reduction Program (HRRP) unfairly penalized safety‐net hospitals treating patients with high social and functional risk, in 2019 HRRP introduced a “peer‐grouping” methodology comparing hospital readmission performance only to other hospitals with similar proportions of patients dually eligible for Medicaid and Medicare. Whether the new methodology fairly accounts for differences in social and functional risk factors is unknown. Using a unique dataset that adjusts for patient‐level social and functional factors and community‐level proxies, we examined changes in risk‐standardized readmission rates (RSRRs) for each peer group when adding these factors.
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