HRRP

Legumes can establish a mutual association with soil-derived nitrogen-fixing bacteria called 'rhizobia' forming lateral root organs called root nodules. Rhizobia inside the root nodules get transformed into 'bacteroids' that can fix atmospheric nitrogen to ammonia for host plants in return for nutrients and shelter. A substantial 200 million tons of nitrogen is fixed annually through biological nitrogen fixation. Consequently, the symbiotic mechanism of nitrogen fixation is utilized worldwide for sustainable agriculture and plays a crucial role in the Earth's ecosystem...

BACKGROUND: Hospitalizations account for almost one-third of the US $4.1 trillion health care cost in the United States. A substantial portion of these hospitalizations are attributed to readmissions, which led to the establishment of the Hospital Readmissions Reduction Program (HRRP) in 2012. The HRRP reduces payments to hospitals with excess readmissions. In 2018, >US $700 million was withheld; this is expected to exceed US $1 billion by 2022. More importantly, there is nothing more physically and emotionally taxing for readmitted patients and demoralizing for hospital physicians, nurses, and administrators...

OBJECTIVE: Medicare's Hospital Readmissions Reduction Program (HRRP) financially penalizes "excessive" post-operative readmissions. Concerned with creating a double-standard for institutions treating a high percentage of financially vulnerable patients, Medicare elected to exclude socioeconomic status (SES) from its risk-adjustment model. However, recent evidence suggests that safety-net hospitals (SNHs) caring for many low-SES patients are disproportionately penalized under the HRRP...

OBJECTIVE: To assess whether Medicare's Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in severe fall-related injuries (FRIs). DATA SOURCES AND STUDY SETTING: Secondary data from Medicare were used. STUDY DESIGN: Using an event study design, among older (≥65) Medicare fee-for-service beneficiaries, we assessed changes in 30- and 90-day FRI readmissions before and after HRRP's announcement (April 2010) and implementation (October 2012) for conditions targeted by the HRRP (acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia) versus "non-targeted" (gastrointestinal) conditions...

PURPOSE OF REVIEW: This review aims to summarize the current burden of heart failure (HF) in the United States, specifically in patients with low socioeconomic position (SEP), and synthesize recommendations to prevent HF-related hospital readmissions in this vulnerable population. RECENT FINDINGS: As treatments have improved, HF-related mortality has declined over time, resulting in more patients living with HF. This has led to an increase in hospitalizations, however, putting excess strain on our healthcare system...

Radar high-resolution range profile (HRRP) provides geometric and structural information of target, which is important for radar automatic target recognition (RATR). However, due to the limited information dimension of HRRP, achieving accurate target recognition is challenging in applications. In recent years, with the rapid development of radar components and signal processing technology, the acquisition and use of target multi-frequency and polarization scattering information has become a significant way to improve target recognition performance...

OBJECTIVE: To assess the association of Private, Medicare, and Medicaid/Uninsured insurance type with 30-day Emergency Department visits/Observation Stays (EDOS), readmissions, and costs in a safety-net hospital (SNH) serving diverse socioeconomic status patients. SUMMARY BACKGROUND DATA: Medicare's Hospital Readmission Reduction Program (HRRP) disproportionately penalizes SNHs. METHODS: This retrospective cohort study used inpatient National Surgical Quality Improvement Program (2013-2019) data merged with cost data...

BACKGROUND: Although the immediate effect of financial penalties imposed by the Hospital Readmissions Reduction Program (HRRP) was a decrease in 30-day hospital readmission rates, the long-term effects are unclear. The authors studied 30-day readmissions before and immediately after HRRP penalties and during the most recent period before the COVID-19 pandemic and examined whether readmission trends differed between penalized and non-penalized hospitals. METHODS: Centers for Medicare & Medicaid Services hospital archive data and US Census Bureau data were used to analyze hospital characteristics, including readmission penalty status, and hospital service area (HSA) demographic information, respectively...

Purpose: Pharmacists play a key role in preventing medication errors during transitions of care and preventing hospital readmissions through medication reconciliation (MR) programs. This study retrospectively evaluated the implementation of a standardized pharmacy residentdriven MR program for patients at high risk for readmission as defined by the Hospital Readmissions Reduction Program (HRRP). Methods: This was a single-center, retrospective cross sectional study of a pharmacy resident-driven MR program including patients at high risk of readmission defined by HRRP...

The Hospital Readmissions Reduction Program (HRRP) works to temper nationally rising readmission rates. Total knee arthroplasty (TKA) and total hip arthroplasty (THA) have a 30-day readmission cost burden of $889,300 and $689,400, respectively. No research has compared TKA and THA readmission rates by region and Medicaid expansion status. This study compares THA and TKA readmission rates in the United States by region, Medicaid status, and performance. One-way ANOVAs were conducted to determine the regions with the highest and lowest mean excess readmission ratios (ERRs)...

This article deals with the analysis of backscattering at automatic target recognition (ATR) by ground-based radar located on rough terrain surfaces, using the properties of wave polarization. The purpose of the study is to examine and compare linear and circular polarized reflected waves, which can be described by decomposition theorems. Coherent decompositions (Pauli, Krogager, Cameron decomposition) are considered in the case of a rough terrain, for which the advantage of the Pauli decomposition has been shown...

BACKGROUND: Hospital readmissions following acute myocardial infarction (AMI) pose a significant economic burden on health care utilization. The hospital readmission reduction program (HRRP) enacted in 2012 focused on reducing readmissions by penalizing CMS Medicare hospitals. We aim to assess the trend of readmissions after AMI hospitalization between 2010-2019 and assess the impact of HRRP. METHODS: The NRD was queried to identify AMI hospitalizations between 2010 and 2019...

In Uruguayan soils, populations of native and naturalized rhizobia nodulate white clover. These populations include efficient rhizobia but also parasitic strains, which compete for nodule occupancy and hinder optimal nitrogen fixation by the grassland. Nodulation competitiveness assays using gusA -tagged strains proved a high nodule occupancy by the inoculant strain U204, but this was lower than the strains with intermediate efficiencies, U268 and U1116. Clover biomass production only decreased when the parasitic strain UP3 was in a 99:1 ratio with U204, but not when UP3 was at equal or lower numbers than U204...

OBJECTIVE: To evaluate whether Medicare's Hospital Readmissions Reduction Program (HRRP) is associated with increased observation stay use. DATA SOURCES AND STUDY SETTING: A nationally representative sample of fee-for-service Medicare claims, January 2009 - September 2016. STUDY DESIGN: Using a difference-in-difference (DID) design, we modeled changes in observation stays as a proportion of total hospitalizations, separately comparing the initial (acute myocardial infarction, pneumonia, heart failure) and subsequent (chronic obstructive pulmonary disease) target conditions with a control group of nontarget conditions...

To date, there has been a notable lack of peer-reviewed or publicly available data documenting rates of hospital quality outcomes and patient safety events during the pandemic era. The dearth of evidence is perhaps related to the US healthcare system triaging resources towards patient care and away from reporting and research, and also reflects that data used in publicly reported hospital quality rankings and ratings typically lag 2-5 years . At our institution, a learning health system assessment is underway to evaluate how patient safety was affected by the pandemic...

Medicare has increased the use of performance pay incentives for hospitals, with the goal of increasing care coordination across providers, reducing market frictions, and ultimately to improve quality of care. This paper provides new empirical evidence by using novel operations and claims data from a large, independent home health care firm with the Hospital Readmissions Reduction Program (HRRP) penalty on hospitals providing identifying variation. We find that the penalty incentive to reduce re-hospitalizations passed through from hospitals to the firm for at least some types of patients, since it provided more care inputs for heart disease patients discharged from hospitals at greater penalty risk and that contributed more patients to the firm...

The stepped-frequency (SF) waveform is highly sensitive to the target motion, which induces range shift and echo spread in a high-range-resolution profile (HRRP). This paper proposes a method based on a cross-transmitted double-stepped frequency (DSF) waveform and the phase-cancellation technique. The proposed method obtains the stationary HRRP of the moving targets according to the inverse discrete Fourier transform (IDFT) and complex multiplication. The results also show that the proposed method eliminates the generated false peaks from the existing methods...

IMPORTANCE: Decreases in 30-day readmissions following the implementation of the Medicare Hospital Readmissions Reduction Program (HRRP) have occurred against the backdrop of increasing hospital observation stay use, yet observation stays are not captured in readmission measures. OBJECTIVE: To examine whether the HRRP was associated with decreases in 30-day readmissions after accounting for observation stays. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included a 20% sample of inpatient admissions and observation stays among Medicare fee-for-service beneficiaries from January 1, 2009, to December 31, 2015...

Value-based payment programs adjust payments to providers based on spending, quality, or health outcomes. Concern that these programs penalize providers disproportionately serving vulnerable patients prompted calls to adjust performance measures for social risk factors. We reviewed fourteen studies of social risk adjustment in Medicare's Hospital Readmissions Reduction Program (HRRP), a value-based payment model that initially did not adjust for social risk factors but subsequently began to do so. Seven studies found that adding social risk factors to the program's base risk-adjustment model (which adjusts only for age, sex, and comorbidities) reduced differences in risk-adjusted readmissions and penalties between safety-net hospitals and other hospitals...

RATIONALE: COPD is the 5th-leading cause of admissions and third-leading cause of readmissions among US adults. Recent policies instituted financial penalties for excessive COPD readmissions. OBJECTIVES: To evaluate changes in the quality of care for patients hospitalized for COPD following implementation of the Hospital Readmissions Reduction Program (HRRP). METHODS: Retrospective cohort study of patients older than 40 years hospitalized for COPD across 995 US hospitals (Premier Healthcare Database)...