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Safety-net hospitals had larger average penalties than non-safety net hospitals under the Hospital Readmissions Reduction Program in fiscal year 2013, but that difference had disappeared by 2016, according to a  published today in the Journal of the American Medical Association. In the Value-Based Purchasing Program, safety-net hospitals no longer had an average negative adjustment by 2016 but had a smaller average bonus than non-safety net hospitals, which began averaging a small bonus in 2015, the study found. “The improved HRRP performance among safety-net hospitals may be associated with improvements in readmission rates for heart failure and pneumonia, despite populations treated at safety-net hospitals requiring more resources to achieve similar readmission rates,” the authors said. “The changes in the VBP adjustments reflect both improved performance and CMS changes to the weighting applied to the VBP measures.” Safety-net hospitals were defined as those in the top quartile of the Medicare disproportionate share percentage in FY 2013.