As of 2015, about three-quarters of the reporting hospitals were penalized by Medicare. Tellingly, major teaching hospitals—which tend to see more difficult patients—were disproportionately affected.34 So were hospitals in poverty-stricken areas, where patients were less likely to be well taken care of (or to take care of themselves) after their initial discharge from the hospital.35 Attaining the goal of reduced admissions depends not only on the steps that the hospital takes to educate the patient and provide necessary medications, but also on many factors over which the hospital has little
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