Kocher and Adashi’s commentary in the  Jan 26th JAMA accurately and tragically cites the Accountable Care Act as follows: “With respect to hospital readmissions, the common strategic thread that runs through the ACA is incentivized coordination of care across transitions. As such, this policy tack considers that hospital readmissions (the avoidable byproduct of fragmented and ill-incentivized health care delivery) will respond to payment reform.”

It is true. The ACA does blame “ill-incentivized health care” for excess readmissions, ignoring the reality that readmissions are most strongly associated with poverty (an ill-advised social condition). Misidentifying causal factors leads to faulty conclusions, and faulty conclusions breed faulty regulations and payment incentives. And so it is in the ACA. Thanks to Kocher and Adashi for illuminating this outrage.