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In a study published  this week in JAMA Pediatrics, adjusting for social determinants of health changed hospitals’ penalty status on a readmissions-based pay-for-performance measure. The study compared the performance of 43 children’s hospitals on a readmissions-based pay-for-performance model derived from state Medicaid policies before and after adjusting for four social determinants of health: race, ethnicity, payer and median household income for the patient’s home zip code. “We found that SDH adjustment changed the [potentially preventable readmission] penalty status of 7% and 11.6% of hospitals using 15-day and 30-day readmission windows, respectively,” the authors said. “These findings demonstrate the contribution of select, easily available SDH measures to hospital P4P measures, such as readmissions, and show that SDH adjustment can affect which hospitals are penalized.”