Sandhu AT, et al. - As the Hospital Readmission Reduction Program (HRRP), announced in 2010, penalizes hospitals with high readmissions for multiple conditions including heart failure, a comparison was made of heart failure readmission and mortality rates between hospitals exposed to HRRP financial penalties vs critical access hospitals (CAHs) not subject to the penalty between 2005 and 2016 using 3-year moving averages from Hospital Compare. After the start of HRRP, a 0.60% annual decrease in heart failure readmissions was noted in CAHs. An additional 0.13% annual decrease was noted in HRRP-exposed hospitals vs CAHs. Only modest reductions in readmissions were associated with the introduction of financial penalties. The association between HRRP penalties and mortality was noted to vary with model specifications.