Monday, October 1, marked a date hospitals knew was coming since March 2010: the beginning of federal fiscal year 2013, and the initiation of the CMS Readmission Reduction Program. When the penalties rolled out consistent with the original concept, readmissions topped the agenda of hospital executive team meetings across the nation. It will be imperative to understand how hospitals—safety net and otherwise—move from a baseline of high readmissions to expected or lower-than-expected readmissions; the field is still nascent in hospital-wide results. It will also be important to study how hospitals that primarily serve underserved populations adapt and extend their partnership base with community health centers, community agencies, Medicaid payers, and other stakeholders to more effectively address the complexities of the social, economic, and behavioral drivers of hospital utilization.