On December 7, 2016 the Alliance and United Hospital Fund convened a roundtable focused on patient refusals of home health care services. The subsquent discussions, along with studies from roundtable participants, contributed to a final report on the impact of patient refusals on outcomes and rehospitalizations. One study, conducted by Kathryn Bowles, PhD, of the Visiting Nurse Service of New York and the University of Pennsylvania, found that 28 percent of eligible patients in the study refused home health care services; those who refused were more than twice as likely to be rehospitalized.