A, Risk-adjusted ORs for readmission and death in the full cohort (relative to 2007-2008). The adjusted odds of readmission declined throughout the study period, while adjusted odds of mortality initially increased but then returned to baseline levels. Despite lack of financial penalties, the Veterans Affairs Health Care System achieved steady reductions in adjusted odds of readmission and avoided concurrent increases in mortality. Risk-adjusted ORs of 30-day readmission and death in patients with left ventricular ejection fraction (LVEF) less than 40% (n = 47 790) (B) and LVEF of 40% or greater (n = 71 004) (C). There were 8496 readmissions and 1565 deaths at 30 days among patients with LVEF less than 40%. There were 10 340 readmissions and 2258 deaths at 30 days among patients with LVEF of 40% or more. There were similar trends in readmission reduction for both LVEF strata, indicating that readmission reduction interventions may have similar effectiveness in these populations, while there were no significant changes in mortality regardless of strata.