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Hospital readmission within 30 days is undesirable and costly. Most programs and studies have focused on the Medicare population and readmission prevention through discharge planning; less is understood about how Medicaid might reduce readmissions to improve outcomes and control program costs. The objective of this study was to estimate the relationship between the Colorado Medicaid Accountable Care Collaborative (ACC) and 30-day hospital readmission rates. A difference-in-differences design was used to compare 30-day readmi