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https://www.readbyqxmd.com/read/28395006/association-between-hospitals-engagement-in-value-based-reforms-and-readmission-reduction-in-the-hospital-readmission-reduction-program
#1
Andrew M Ryan, Sam Krinsky, Julia Adler-Milstein, Cheryl L Damberg, Kristin A Maurer, John M Hollingsworth
Importance: Medicare is experimenting with numerous concurrent reforms aimed at improving quality and value for hospitals. It is unclear if these myriad reforms are mutually reinforcing or in conflict with each other. Objective: To evaluate whether hospital participation in voluntary value-based reforms was associated with greater improvement under Medicare's Hospital Readmission Reduction Program (HRRP). Design, Setting, and Participants: Retrospective, longitudinal study using publicly available national data from Hospital Compare on hospital readmissions for 2837 hospitals from 2008 to 2015...
April 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28027367/association-between-hospital-penalty-status-under-the-hospital-readmission-reduction-program-and-readmission-rates-for-target-and-nontarget-conditions
#2
COMPARATIVE STUDY
Nihar R Desai, Joseph S Ross, Ji Young Kwon, Jeph Herrin, Kumar Dharmarajan, Susannah M Bernheim, Harlan M Krumholz, Leora I Horwitz
Importance: Readmission rates declined after announcement of the Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for excess readmissions for acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Objective: To compare trends in readmission rates for target and nontarget conditions, stratified by hospital penalty status. Design, Setting, and Participants: Retrospective cohort study of Medicare fee-for-service beneficiaries older than 64 years discharged between January 1, 2008, and June 30, 2015, from 2214 penalty hospitals and 1283 nonpenalty hospitals...
December 27, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28024302/readmission-rates-after-passage-of-the-hospital-readmissions-reduction-program-a-pre-post-analysis
#3
Jason H Wasfy, Corwin Matthew Zigler, Christine Choirat, Yun Wang, Francesca Dominici, Robert W Yeh
Background: Whether hospitals with the highest risk-standardized readmission rates (RSRRs) subsequently experienced the greatest improvement after passage of the Medicare Hospital Readmissions Reduction Program (HRRP) is unknown. Objective: To evaluate whether passage of the HRRP was followed by acceleration in improvement in 30-day RSRRs after hospitalizations for acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia and whether the lowest-performing hospitals had faster acceleration in improvement after passage of the law than hospitals that were already performing well...
March 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27929411/a-robust-range-grating-lobe-suppression-method-based-on-image-contrast-for-stepped-frequency-sar
#4
Wen-Bin Gao, Teng Long, Ze-Gang Ding, Yi-Rong Wu
The magnitude error and phase error (MEPE) in the transfer function of a stepped-frequency synthetic aperture radar (SAR) system results in a periodic MEPE in the synthesized wideband waveform (SWW), which induces the grating lobes in the high-resolution range profile (HRRP). In this paper, a robust data-driven grating lobe suppression (GLS) method is proposed. Based on a contrast-based error estimation method and the grating lobes of the brightest scatterers in the SAR image, the periodic MEPE can be robustly estimated using the proposed method...
December 6, 2016: Sensors
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
#5
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/27766634/reliability-of-30-day-readmission-measures-used-in-the-hospital-readmission-reduction-program
#6
Michael P Thompson, Cameron M Kaplan, Yu Cao, Gloria J Bazzoli, Teresa M Waters
OBJECTIVE: To assess the reliability of risk-standardized readmission rates (RSRRs) for medical conditions and surgical procedures used in the Hospital Readmission Reduction Program (HRRP). DATA SOURCES: State Inpatient Databases for six states from 2011 to 2013 were used to identify patient cohorts for the six conditions used in the HRRP, which was augmented with hospital characteristic and HRRP penalty data. STUDY DESIGN: Hierarchical logistic regression models estimated hospital-level RSRRs for each condition, the reliability of each RSRR, and the extent to which socioeconomic and hospital factors further explain RSRR variation...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27755392/the-hospital-score-predicts-potentially-preventable-30-day-readmissions-in-conditions-targeted-by-the-hospital-readmissions-reduction-program
#7
Robert E Burke, Jeffrey L Schnipper, Mark V Williams, Edmondo J Robinson, Eduard E Vasilevskis, Sunil Kripalani, Joshua P Metlay, Grant S Fletcher, Andrew D Auerbach, Jacques D Donzé
BACKGROUND/OBJECTIVES: New tools to accurately identify potentially preventable 30-day readmissions are needed. The HOSPITAL score has been internationally validated for medical inpatients, but its performance in select conditions targeted by the Hospital Readmission Reduction Program (HRRP) is unknown. DESIGN: Retrospective cohort study. SETTING: Six geographically diverse medical centers. PARTICIPANTS/EXPOSURES: All consecutive adult medical patients discharged alive in 2011 with 1 of the 4 medical conditions targeted by the HRRP (acute myocardial infarction, chronic obstructive pulmonary disease, pneumonia, and heart failure) were included...
March 2017: Medical Care
https://www.readbyqxmd.com/read/27733074/financial-impact-of-ivabradine-on-reducing-heart-failure-penalties-under-the-hospital-readmission-reduction-program
#8
Anuraag R Kansal, Stanimira Krotneva, Ali Tafazzoli, Harshali K Patel, Jeffrey S Borer, Michael Böhm, Michel Komajda, Juan Maya, Luigi Tavazzi, Ian Ford, Adrian Kielhorn
OBJECTIVE: The introduction of the Hospital Readmission Reduction Program (HRRP) has led to renewed interest in developing strategies to reduce 30 day readmissions among patients with heart failure (HF). In this study, a model was developed to investigate whether the addition of ivabradine to a standard-of-care (SoC) treatment regimen for patients with HF would reduce HRRP penalties incurred by a hypothetical hospital with excess 30 day readmissions. RESEARCH DESIGN: A model using a Monte Carlo simulation framework was developed...
February 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27732093/action-is-the-foundational-key-to-all-success
#9
Elena Barengolts
CMS = Centers for Medicare and Medicaid Services COPD = chronic obstructive pulmonary disease H2H = Hospital-to-Home HF = heart failure HRRP = Hospital Re-admissions Reduction Program.
October 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27556831/opinions-on-the-hospital-readmission-reduction-program-results-of-a-national-survey-of-hospital-leaders
#10
Karen E Joynt, Jose E Figueroa, John Oray, Ashish K Jha
OBJECTIVES: To determine the opinions of US hospital leadership on the Hospital Readmissions Reduction Program (HRRP), a national mandatory penalty-for-performance program. STUDY DESIGN: We developed a survey about federal readmission policies. We used a stratified sampling design to oversample hospitals in the highest and lowest quintile of performance on readmissions, and hospitals serving a high proportion of minority patients. METHODS: We surveyed leadership at 1600 US acute care hospitals that were subject to the HRRP, and achieved a 62% response rate...
August 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27551097/disulfide-cross-linking-influences-symbiotic-activities-of-nodule-peptide-ncr247
#11
Mohammed Shabab, Markus F F Arnold, Jon Penterman, Andrew J Wommack, Hartmut T Bocker, Paul A Price, Joel S Griffitts, Elizabeth M Nolan, Graham C Walker
Interactions of rhizobia with legumes establish the chronic intracellular infection that underlies symbiosis. Within nodules of inverted repeat-lacking clade (IRLC) legumes, rhizobia differentiate into nitrogen-fixing bacteroids. This terminal differentiation is driven by host nodule-specific cysteine-rich (NCR) peptides that orchestrate the adaptation of free-living bacteria into intracellular residents. Medicago truncatula encodes a family of >700 NCR peptides that have conserved cysteine motifs. NCR247 is a cationic peptide with four cysteines that can form two intramolecular disulfide bonds in the oxidized forms...
September 6, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27503972/accounting-for-patients-socioeconomic-status-does-not-change-hospital-readmission-rates
#12
Susannah M Bernheim, Craig S Parzynski, Leora Horwitz, Zhenqiu Lin, Michael J Araas, Joseph S Ross, Elizabeth E Drye, Lisa G Suter, Sharon-Lise T Normand, Harlan M Krumholz
There is an active public debate about whether patients' socioeconomic status should be included in the readmission measures used to determine penalties in Medicare's Hospital Readmissions Reduction Program (HRRP). Using the current Centers for Medicare and Medicaid Services methodology, we compared risk-standardized readmission rates for hospitals caring for high and low proportions of patients of low socioeconomic status (as defined by their Medicaid status or neighborhood income). We then calculated risk-standardized readmission rates after additionally adjusting for patients' socioeconomic status...
August 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27442307/hospital-participation-in-acos-associated-with-other-value-based-program-improvement
#13
David Muhlestein, Tianna Tu, Katelyn de Lisle, Thomas Merrill
OBJECTIVES: This paper analyzes whether hospital participation in an accountable care organization (ACO) impacts a hospital's quality improvement and cost reduction outcomes in other value-based purchasing (VBP) programs, including the Hospital Value-Based Purchasing Program (HVBP), the Hospital Readmissions Reduction Program (HRRP), and the Hospital-Acquired Conditions (HAC) Reduction Program. STUDY DESIGN: Using VBP performance data and Leavitt Partners' ACO data, 2 analyses were performed: 1) a descriptive comparison of VBP performance of hospital ACOs compared with non-ACO hospitals, and 2) a longitudinal analysis of hospitals that became part of an ACO during the second year of performance data...
2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27416886/does-it-pay-to-penalize-hospitals-for-excess-readmissions-intended-and-unintended-consequences-of-medicare-s-hospital-readmissions-reductions-program
#14
Jennifer Mellor, Michael Daly, Molly Smith
To incentivize hospitals to provide better quality care at a lower cost, the Affordable Care Act of 2010 included the Hospital Readmissions Reduction Program (HRRP), which reduces payments to hospitals with excess 30-day readmissions for Medicare patients treated for certain conditions. We use triple difference estimation to identify the HRRP's effects in Virginia hospitals; this method estimates the difference in changes in readmission over time between patients targeted by the policy and a comparison group of patients and then compares those difference-in-differences estimates in patients treated at hospitals with readmission rates above the national average (i...
July 15, 2016: Health Economics
https://www.readbyqxmd.com/read/27311949/indication-for-lower-extremity-revascularization-and-hospital-profiling-of-readmissions
#15
COMPARATIVE STUDY
Andrew A Gonzalez, Celeste G Cruz, Shantanu Dev, Nicholas H Osborne
BACKGROUND: Surgical readmissions are common, costly, and the focus of national quality improvement efforts. Given the relatively high readmission rates among vascular patients, pay-for-performance initiatives such as Medicare's Hospital Readmissions Reduction Program (HRRP) have targeted vascular surgery for increased scrutiny in the near future. Yet, the extent to which institutional case mix influences hospital profiling remains unexplored. We sought to evaluate whether higher readmission rates in vascular surgery are a reflection of worse performance or of treating sicker patients...
August 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27271629/a-novel-monopulse-angle-estimation-method-for-wideband-lfm-radars
#16
Yi-Xiong Zhang, Qi-Fan Liu, Ru-Jia Hong, Ping-Ping Pan, Zhen-Miao Deng
Traditional monopulse angle estimations are mainly based on phase comparison and amplitude comparison methods, which are commonly adopted in narrowband radars. In modern radar systems, wideband radars are becoming more and more important, while the angle estimation for wideband signals is little studied in previous works. As noise in wideband radars has larger bandwidth than narrowband radars, the challenge lies in the accumulation of energy from the high resolution range profile (HRRP) of monopulse. In wideband radars, linear frequency modulated (LFM) signals are frequently utilized...
2016: Sensors
https://www.readbyqxmd.com/read/27261414/vulnerable-hospitals-and-cancer-surgery-readmissions-insights-into-the-unintended-consequences-of-the-patient-protection-and-affordable-care-act
#17
Young Hong, Chaoyi Zheng, Elizabeth Hechenbleikner, Lynt B Johnson, Nawar Shara, Waddah B Al-Refaie
BACKGROUND: Penalties from the Hospital Readmission Reduction Program can push financially strained, vulnerable patient-serving hospitals into additional hardship. In this study, we quantified the association between vulnerable hospitals and readmissions and examined the respective contributions of patient- and hospital-related factors. METHODS: A total of 110,857 patients who underwent major cancer operations were identified from the 2004-2011 State Inpatient Database of California...
July 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27167208/copd-readmissions-addressing-copd-in-the-era-of-value-based-health-care
#18
REVIEW
Tina Shah, Valerie G Press, Megan Huisingh-Scheetz, Steven R White
Of those patients hospitalized for an exacerbation of COPD, one in five will require rehospitalization within 30 days. Many developed countries are now implementing policies to increase care quality while controlling costs for COPD, known as value-based health care. In the United States, COPD is part of Medicare's Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals for excess 30-day, all-cause readmissions after a hospitalization for an acute exacerbation of COPD, despite minimal evidence to guide hospitals on how to reduce readmissions...
October 2016: Chest
https://www.readbyqxmd.com/read/26761728/the-impact-of-the-medicare-hospital-readmission-reduction-program-in-new-york-state
#19
MULTICENTER STUDY
Brian E McGarry, Albert A Blankley, Yue Li
BACKGROUND: Medicare's Hospital Readmission Reduction Program (HRRP) created clear financial incentives for hospitals to prevent readmissions. Although existing evidence suggests readmission rates have been declining, the direct contribution of this policy to these reductions is unclear. Furthermore, it is unknown whether HRRP has produced unintended effects, including the substitution of outpatient hospital care for readmissions. OBJECTIVES: To determine the effect of HRRP in New York State on both the likelihood of being readmitted and returning to hospital emergency department (ED) care within 30 days of discharge...
February 2016: Medical Care
https://www.readbyqxmd.com/read/26655922/impact-of-risk-adjustment-for-socioeconomic-status-on-risk-adjusted-surgical-readmission-rates
#20
Laurent G Glance, Arthur L Kellermann, Turner M Osler, Yue Li, Wenjun Li, Andrew W Dick
OBJECTIVE: To assess whether differences in readmission rates between safety-net hospitals (SNH) and non-SNHs are due to differences in hospital quality, and to compare the results of hospital profiling with and without SES adjustment. BACKGROUND: In response to concerns that quality measures unfairly penalizes SNH, NQF recently recommended that performance measures adjust for socioeconomic status (SES) when SES is a risk factor for poor patient outcomes. METHODS: Multivariate regression was used to examine the association between SNH status and 30-day readmission after major surgery...
April 2016: Annals of Surgery
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