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Medicare risk adjustment

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https://www.readbyqxmd.com/read/27927839/does-medicare-advantage-reduce-racial-disparity-in-30-day-rehospitalization-for-medicare-beneficiaries
#1
Yue Li, Xi Cen, Xueya Cai, Dongliang Wang, Caroline Pinto Thirukumaran, Laurent G Glance
This study determined potential racial and ethnic disparities in risk for all-cause 30-day readmission among traditional Medicare (TM) and Medicare Advantage (MA) beneficiaries initially hospitalized for acute myocardial infarction, congestive heart failure, or pneumonia. Our analyses of New York State hospital administrative data between 2009 and 2012 found that overall 30-day readmission rate declined from 22.0% in 2009 to 20.7% in 2012 for TM beneficiaries, and from 20.2% in 2009 to 17.9% in 2012 for MA beneficiaries...
December 6, 2016: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/27926558/postoperative-venous-thromboembolism-in-patients-undergoing-abdominal-surgery-for-ibd-a-common-but-rarely-addressed-problem
#2
Matthew T Brady, Gregory J Patts, Amy Rosen, George Kasotakis, Jeffrey J Siracuse, Teviah Sachs, Angela Kuhnen, Hiroko Kunitake
BACKGROUND: Venous thromboembolism after abdominal surgery occurs in 2% to 3% of patients with Crohn's disease and ulcerative colitis. However, no evidence-based guidelines currently exist to guide postdischarge prophylactic anticoagulation. OBJECTIVE: We sought to determine the use of postoperative postdischarge venous thromboembolism chemical prophylaxis, 90-day venous thromboembolism rates, and factors associated with 90-day thromboembolic events in IBD patients following abdominal surgery...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27919104/dual-health-care-system-use-and-high-risk-prescribing-in-patients-with-dementia-a-national-cohort-study
#3
Joshua M Thorpe, Carolyn T Thorpe, Walid F Gellad, Chester B Good, Joseph T Hanlon, Maria K Mor, John R Pleis, Loren J Schleiden, Courtney Harold Van Houtven
Background: Recent federal policy changes attempt to expand veterans' access to providers outside the Department of Veterans Affairs (VA). Receipt of prescription medications across unconnected systems of care may increase the risk for unsafe prescribing, particularly in persons with dementia. Objective: To investigate the association between dual health care system use and potentially unsafe medication (PUM) prescribing. Design: Retrospective cohort study...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27917464/relation-of-dysglycemia-to-structural-brain-changes-in-a-multiethnic-elderly-cohort
#4
Christiane Reitz, Vanessa A Guzman, Atul Narkhede, Charles DeCarli, Adam M Brickman, José A Luchsinger
OBJECTIVES: Abnormally high glucose levels (dysglycemia) increase with age. Epidemiological studies suggest that dysglycemia is a risk factor for cognitive impairment but the underlying pathophysiological mechanisms remain unclear. The objective of this study was to examine the relation of dysglycemia clinical categories (normal glucose tolerance (NGT), pre-diabetes, undiagnosed diabetes, known diabetes) with brain structure in older adults. We also assessed the relation between dysglycemia and cognitive performance...
December 5, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27917014/contextual-ecological-and-organizational-variations-in-risk-adjusted-copd-and-asthma-hospitalization-rates-of-rural-medicare-beneficiaries
#5
Thomas T H Wan, Yi-Ling Lin, Judith Ortiz
The purpose of this study is to examine what factors contributing to the variability in chronic obstructive pulmonary disorder (COPD) and asthma hospitalization rates when the influence of patient characteristics is being simultaneously considered by applying a risk adjustment method. A longitudinal analysis of COPD and asthma hospitalization of rural Medicare beneficiaries in 427 rural health clinics (RHCs) was conducted utilizing administrative data and inpatient and outpatient claims from Region 4. The repeated measures of risk-adjusted COPD and asthma admission rate were analyzed by growth curve modeling...
2016: Research in the Sociology of Health Care
https://www.readbyqxmd.com/read/27908393/association-of-30-day-readmission-metric%C3%A2-for-heart-failure-under-the-hospital%C3%A2-readmissions-reduction-program%C3%A2-with-quality-of-care-and%C3%A2-outcomes
#6
Ambarish Pandey, Harsh Golwala, Haolin Xu, Adam D DeVore, Roland Matsouaka, Michael Pencina, Dharam J Kumbhani, Adrian F Hernandez, Deepak L Bhatt, Paul A Heidenreich, Clyde W Yancy, James A de Lemos, Gregg C Fonarow
OBJECTIVES: This study sought to determine whether processes of care and long-term clinical outcomes for heart failure (HF) admissions across Get With The Guidelines-Heart Failure (GWTG-HF) program participating centers differ according to HF-specific risk-adjusted 30-day readmission rates (excess readmission ratio [ERR]) as determined by the Hospital Readmission Reduction Program (HRRP). BACKGROUND: HRRP penalizes hospitals with higher than expected risk-adjusted 30-day readmission rates (ERR >1) for common conditions including HF...
December 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27904301/prescription-drug-data-might-help-protect-obamacare-medication-use-will-be-integrated-into-marketplace-plan-risk-adjustments
#7
Stephen Barlas
The Centers for Medicare and Medicaid Services' addition of drug utilization categories to the risk-assessment process aims to make scores more sensitive and accurate, which may help stem the exodus of companies from the marketplace.
November 2016: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/27898697/risk-of-death-influences-regional-variation-in-intensive-care-unit-admission-rates-among-the-elderly-in-the-united-states
#8
Colin R Cooke
RATIONALE: The extent to which geographic variability in ICU admission across the United States is driven by patients with lower risk of death is unknown. OBJECTIVES: To determine whether patients at low to moderate risk of death contribute to geographic variation in ICU admission. METHODS: Retrospective cohort of hospitalizations among Medicare beneficiaries (age > 64 years) admitted for ten common medical and surgical diagnoses (2004 to 2009)...
2016: PloS One
https://www.readbyqxmd.com/read/27893045/association-of-3-different-antihypertensive-medications-with-hip-and-pelvic-fracture-risk-in-older-adults-secondary-analysis-of-a-randomized-clinical-trial
#9
Rachel Puttnam, Barry R Davis, Sara L Pressel, Paul K Whelton, William C Cushman, Gail T Louis, Karen L Margolis, Suzanne Oparil, Jeffrey Williamson, Alokananda Ghosh, Paula T Einhorn, Joshua I Barzilay
Importance: On the basis of observational studies, the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Data from randomized clinical trials are lacking. Objective: To examine whether the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with nonuse. Design, Setting, and Participants: Using Veterans Affairs and Medicare claims data, this study examined hip and pelvic fracture hospitalizations in Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial participants randomized to first-step therapy with a thiazide-type diuretic (chlorthalidone), a calcium channel blocker (amlodipine besylate), or an angiotensin-converting enzyme inhibitor (lisinopril)...
November 21, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27893028/out-of-pocket-spending-and-financial-burden-among-medicare-beneficiaries-with-cancer
#10
Amol K Narang, Lauren Hersch Nicholas
Importance: Medicare beneficiaries with cancer are at risk for financial hardship given increasingly expensive cancer care and significant cost sharing by beneficiaries. Objectives: To measure out-of-pocket (OOP) costs incurred by Medicare beneficiaries with cancer and identify which factors and services contribute to high OOP costs. Design, Setting, and Participants: We prospectively collected survey data from 18 166 community-dwelling Medicare beneficiaries, including 1409 individuals who were diagnosed with cancer during the study period, who participated in the January 1, 2002, to December 31, 2012, waves of the Health and Retirement Study, a nationally representative panel study of US residents older than 50 years...
November 23, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27882835/health-care-costs-for-patients-with-heart-failure-escalate-nearly-3-fold-in-final-months-of-life
#11
Engels N Obi, Jason P Swindle, Stuart J Turner, Patricia A Russo, Aylin Altan
BACKGROUND: Heart failure (HF) is a severe chronic disease with growing prevalence and health care burden as well as high mortality. End-of-life cost data for patients with HF may inform disease and medication therapy management. OBJECTIVES: To (a) characterize a real-world sample of patients with HF who died; (b) estimate health care costs for 6 months and semiannually for 24 months, before death; and (c) examine associations between patient characteristics and predeath health care costs...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27874977/relationship-between-age-and-trajectories-of-rehospitalization-risk-in-older-adults
#12
Kumar Dharmarajan, Angela Hsieh, Rachel P Dreyer, Jack Welsh, Li Qin, Harlan M Krumholz
OBJECTIVES: To characterize the magnitude and duration of risk of rehospitalization according to age after hospitalization for heart failure (HF), acute myocardial infarction (AMI), or pneumonia. DESIGN: Retrospective cohort study. SETTING: U.S. hospitals (n = 4,767). PARTICIPANTS: All Medicare fee-for-service beneficiaries aged 65 and older surviving hospitalization for HF, AMI, or pneumonia between October 2012 and December 2013...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27874194/slow-gait-speed-and-risk-of-long-term-nursing-home-residence-in-older-women-adjusting-for-competing-risk-of-mortality-results-from-the-study-of-osteoporotic-fractures
#13
Jennifer G Lyons, Kristine E Ensrud, John T Schousboe, Charles E McCulloch, Brent C Taylor, Timothy C Heeren, Sherri O Stuver, Lisa Fredman
OBJECTIVES: To determine whether slow gait speed increases the risk of costly long-term nursing home residence when accounting for death as a competing risk remains unknown. DESIGN: Longitudinal cohort study using proportional hazards models to predict long-term nursing home residence and subdistribution models with death as a competing risk. SETTING: Community-based prospective cohort study. PARTICIPANTS: Older women (mean age 76...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27871075/comparative-effectiveness-of-renin-angiotensin-system-antagonists-in-maintenance-dialysis-patients
#14
Theresa I Shireman, Jonathan D Mahnken, Milind A Phadnis, Edward F Ellerbeck, James B Wetmore
BACKGROUND/AIMS: Whether angiotensin converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) are differentially associated with reductions in cardiovascular events and mortality in patients receiving maintenance dialysis is uncertain. We compared outcomes between ACE and ARB users among hypertensive, maintenance dialysis patients. METHODS: National retrospective cohort study of hypertensive, Medicare-Medicaid eligible patients initiating chronic dialysis between 1/1/2000 to 12/31/2005...
November 21, 2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27870545/does-medicare-advantage-enrollment-affect-home-healthcare-use
#15
Daniel A Waxman, Lillian Min, Claude M Setodji, Mark Hanson, Neil S Wenger, David A Ganz
OBJECTIVES: To compare home health utilization and clinical outcomes between Medicare beneficiaries in the fee-for-service (FFS) and Medicare Advantage (MA) programs, and to compare regional variation. STUDY DESIGN: We used the 2010 and 2011 Outcome and Assessment Information Set to identify all home health episodes begun in 2010 and to measure 7 clinical home health outcomes that are defined by CMS for public reporting. METHODS: We modeled the probability of home health use, the duration of home health episodes, and each clinical outcome measure as a function of MA versus FFS enrollment and model-specific risk adjustors...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27869994/neighborhood-disadvantage-and-life-space-mobility-are-associated-with-incident-falls-in-community-dwelling-older-adults
#16
Alexander X Lo, Andrew G Rundle, David Buys, Richard E Kennedy, Patricia Sawyer, Richard M Allman, Cynthia J Brown
OBJECTIVES: To determine the relationship between neighborhood-level socioeconomic characteristics, life-space mobility, and incident falls in community-dwelling older adults. DESIGN: Prospective, observational cohort study with a baseline in-home assessment and 6-month telephone follow-up. SETTING: Central Alabama. PARTICIPANTS: Community-dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries (N = 1,000)...
November 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27868212/myelodysplastic-syndromes-and-acute-myeloid-leukemia-after-radiotherapy-for-prostate-cancer-a-population-based-study
#17
Rong Wang, Amer M Zeidan, James B Yu, Pamela R Soulos, Amy J Davidoff, Steven D Gore, Scott F Huntington, Cary P Gross, Xiaomei Ma
BACKGROUND: To understand the impact of radiotherapy on the development of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) among elderly prostate cancer patients. METHODS: We performed a retrospective cohort study of elderly prostate cancer patients diagnosed during 1999-2011 by using the National Cancer Institute's Surveillance, Epidemiology and End Results-Medicare linked database. Competing risk analyses adjusting for patient characteristics were conducted to assess the impact of radiotherapy on the development of subsequent MDS/AML, compared with surgery...
November 21, 2016: Prostate
https://www.readbyqxmd.com/read/27867823/the-burden-of-metastatic-disease-of-the-femur-on-the-medicare-system
#18
Kirollos Gendi, David Hennessy, John Heiner
BACKGROUND: In the United States, over 1,650,000 new cases of cancer are being diagnosed yearly with almost 50 % of them being the top five bone-seeking cancers. Since cancer risk increases with age, this suggests that orthopedic oncology services may be a strain on the Medicare system. The femur is the most common site of long bone metastases. Prophylactic fixation techniques prevent pathologic fractures, reduce morbidities, and enhance the quality of life of patients with femoral metastases...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27866965/proton-pump-inhibitor-use-and-risk-of-hip-fracture-in-kidney-transplant-recipients
#19
Colin R Lenihan, Sumi Sukumaran Nair, Chandan Vangala, Venkat Ramanathan, Maria E Montez-Rath, Wolfgang C Winkelmayer
BACKGROUND: Posttransplantation bone disease is a significant problem, with few well-evidenced therapeutic options. Proton pump inhibitors (PPIs) are associated with hip fracture in the general population and are widely prescribed for kidney transplant recipients. STUDY DESIGN: A case-control study. SETTING & PARTICIPANTS: From the US Renal Data System, we identified from diagnoses and procedures 231 kidney transplant recipients with a first hip fracture...
November 17, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27861759/metabolic-syndrome-and-risk-of-esophageal-adenocarcinoma-in-elderly-patients-in-the-united-states-an-analysis-of-seer-medicare-data
#20
Jennifer Drahos, Winnie Ricker, Ruth M Pfeiffer, Michael B Cook
BACKGROUND: Metabolic syndrome (MetS) is associated with cancer risk and increases the risk of Barrett esophagus, which is the precursor lesion of esophageal adenocarcinoma (EA), primarily in the absence of gastroesophageal reflux disease (GERD). However, to the authors' knowledge, little is known regarding whether MetS is associated with the risk of EA. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database, the authors evaluated whether MetS was associated with EA...
November 8, 2016: Cancer
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