Featured Publications
Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA
Herrin J, Yu H, Venkatesh AK, Desai SM, Thiel CL, Lin Z, Bernheim SM, Horwitz LI. Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA. BMJ Open 2022, 12: e053629. PMID: 35361641, PMCID: PMC8971780, DOI: 10.1136/bmjopen-2021-053629.Peer-Reviewed Original ResearchConceptsAcute care hospitalsHigh-value careStar hospitalsCare hospitalMedicare spendingEligible Medicare patientsRetrospective observational studyCross-sectional studyNon-teaching statusHigh-quality careHigh-quality hospitalsLow-cost hospitalsHigh-cost hospitalsCharacteristics of hospitalsValue of careSecondary outcomesPrimary outcomeMedicare patientsObservational studyMedicare beneficiariesHospitalQuality careOverall star ratingHospital Value
2024
Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance
Nash K, Weerahandi H, Yu H, Venkatesh A, Holaday L, Herrin J, Lin Z, Horwitz L, Ross J, Bernheim S. Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance. JAMA 2024, 331: 111-123. PMID: 38193960, PMCID: PMC10777266, DOI: 10.1001/jama.2023.24874.Peer-Reviewed Original ResearchConceptsBlack patientsPatient populationHospital characteristicsHospital-wide readmission measureDual-eligible patientsHospital patient populationCross-sectional studyMeasures of hospitalHealth care qualityPatient demographicsReadmission ratesClinical outcomesPatient raceEligible hospitalsReadmissionMAIN OUTCOMEReadmission measuresMedicare dataUS hospitalsHospitalCare qualityPatientsMedicaid ServicesOutcomesLower percentage
2022
Perioperative magnetic resonance imaging in breast cancer care: Distinct adoption trajectories among physician patient-sharing networks
Xu X, Soulos PR, Herrin J, Wang SY, Pollack CE, Killelea BK, Forman HP, Gross CP. Perioperative magnetic resonance imaging in breast cancer care: Distinct adoption trajectories among physician patient-sharing networks. PLOS ONE 2022, 17: e0265188. PMID: 35290417, PMCID: PMC8923453, DOI: 10.1371/journal.pone.0265188.Peer-Reviewed Original ResearchConceptsPhysician patient-sharing networksPerioperative magnetic resonance imagingClinical risk factorsMagnetic resonance imagingPatient clinical risk factorsPatient-sharing networksBreast cancer careRisk-adjusted ratesMastectomy usePhysician networksCancer careRisk factorsEnd Results-Medicare databaseCharacteristics of patientsProportion of patientsBreast cancer surgeryComposition of patientsMRI adoptionDistinct trajectoriesMore patientsCancer surgeryClinical outcomesCancer specialistsMRI usePatientsFactors Associated With Disparities in Hospital Readmission Rates Among US Adults Dually Eligible for Medicare and Medicaid
Silvestri D, Goutos D, Lloren A, Zhou S, Zhou G, Farietta T, Charania S, Herrin J, Peltz A, Lin Z, Bernheim S. Factors Associated With Disparities in Hospital Readmission Rates Among US Adults Dually Eligible for Medicare and Medicaid. JAMA Health Forum 2022, 3: e214611. PMID: 35977231, PMCID: PMC8903116, DOI: 10.1001/jamahealthforum.2021.4611.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNon-DE patientsCommunity-level factorsHospital disparitiesHeart failureDE patientsReadmission ratesCohort studyUS hospitalsRisk-adjusted readmission ratesRetrospective cohort studyHospital readmission ratesLow-income older adultsHospital quality improvementEligible patientsHospital readmissionMedicaid eligibility policyCare transitionsMyocardial infarctionState Medicaid policiesWorse outcomesMedicare patientsMAIN OUTCOMEUS adultsPneumonia
2020
Physician trajectories of abandoning long‐course breast radiotherapy and their cost impact
Xu X, Soulos PR, Herrin J, Wang S, Pollack CE, Evans SB, Yu JB, Gross CP. Physician trajectories of abandoning long‐course breast radiotherapy and their cost impact. Health Services Research 2020, 56: 497-506. PMID: 33070305, PMCID: PMC8143683, DOI: 10.1111/1475-6773.13572.Peer-Reviewed Original ResearchConceptsPhysician peer groupsWhole breast irradiationCF-WBIRisk-adjusted ratesBreast radiotherapyPractice patternsLow useChronic Conditions Data WarehouseDistinct practice patternsPatients' clinical characteristicsSetting of radiotherapyAdjuvant breast radiotherapyYears of ageDistinct trajectoriesImportant cost implicationsHigher useAdjuvant radiotherapyClinical characteristicsEligible womenBreast cancerCost implicationsLatent class growth analysisService beneficiariesMedicare programRadiotherapyTimely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data
Li SX, Wang Y, Lama SD, Schwartz J, Herrin J, Mei H, Lin Z, Bernheim SM, Spivack S, Krumholz HM, Suter LG. Timely estimation of National Admission, readmission, and observation-stay rates in medicare patients with acute myocardial infarction, heart failure, or pneumonia using near real-time claims data. BMC Health Services Research 2020, 20: 733. PMID: 32778098, PMCID: PMC7416804, DOI: 10.1186/s12913-020-05611-w.Peer-Reviewed Original ResearchQuality of informed consent documents among US. hospitals: a cross-sectional study
Spatz ES, Bao H, Herrin J, Desai V, Ramanan S, Lines L, Dendy R, Bernheim SM, Krumholz HM, Lin Z, Suter LG. Quality of informed consent documents among US. hospitals: a cross-sectional study. BMJ Open 2020, 10: e033299. PMID: 32434934, PMCID: PMC7247389, DOI: 10.1136/bmjopen-2019-033299.Peer-Reviewed Original ResearchConceptsInformed consent documentsHOSPITAL scoreUS hospitalsMean hospital scoresRetrospective observational studyConsent documentsCross-sectional studyEight-item instrumentService patientsElective proceduresProcedure typeObservational studySurgical proceduresMedicare feeHospitalHospital qualityMeasure scoresInformed consentMost hospitalsSpearman correlationScoresFace validityIndependent ratersOutcomesStakeholder feedbackPatient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm
Smith LB, Desai NR, Dowd B, Everhart A, Herrin J, Higuera L, Jeffery MM, Jena AB, Ross JS, Shah ND, Karaca-Mandic P. Patient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm. International Journal Of Health Economics And Management 2020, 20: 299-317. PMID: 32350680, PMCID: PMC7725279, DOI: 10.1007/s10754-020-09282-2.Peer-Reviewed Original ResearchConceptsPermanent atrial fibrillationType 2 diabetesAtrial fibrillationPermanent atrial fibrillation patientsProvider-level factorsAtrial fibrillation patientsEffective new therapiesPrimary care providersUse of medicationsProvider-level characteristicsUtilization of treatmentHigh-quality health careDronedarone useInterrupted time-series regression modelsFibrillation patientsMedication useDiabetes patientsProvider characteristicsCare providersMedicare feeNew therapiesService claimsFemale providersPatientsMedications
2019
Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization
Weerahandi H, Bao H, Herrin J, Dharmarajan K, Ross JS, Jones S, Horwitz LI. Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization. Journal Of The American Geriatrics Society 2019, 68: 96-102. PMID: 31603248, PMCID: PMC6964248, DOI: 10.1111/jgs.16179.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesHF hospitalizationReadmission ratesReadmission riskHeart failure readmission ratesDays of dischargeHeart failure hospitalizationRetrospective cohort studyHospital discharge practicesMore functional impairmentHome health careFailure hospitalizationHF patientsUnplanned readmissionCohort studyHospital dischargePrimary outcomeRestorative therapySNF stayFunctional impairmentHome healthcare servicesService Medicare dataAdjusted modelCox modelNursing facilitiesHospital Variation in Spending for Lung Cancer Resection in Medicare Beneficiaries
Jean RA, Bongiovanni T, Soulos PR, Chiu AS, Herrin J, Kim N, Xu X, Kim AW, Gross CP. Hospital Variation in Spending for Lung Cancer Resection in Medicare Beneficiaries. The Annals Of Thoracic Surgery 2019, 108: 1710-1716. PMID: 31400321, DOI: 10.1016/j.athoracsur.2019.06.048.Peer-Reviewed Original ResearchConceptsStage I non-small cell lung carcinomaNon-small cell lung carcinomaCell lung carcinomaHospital volumeLung carcinomaComplication rateMedicare beneficiariesExcess costsEnd Results-MedicareIndex hospital costsLung cancer careMean excess costLung cancer resectionHospital-level variationNumber of complicationsLung cancer treatmentEpisode of careCost of careLowest cost quintileIndex hospitalizationCancer resectionHospital factorsPerioperative careHospital variationSurgical hospitalizationAssociation Between Degrees of Separation in Physician Networks and Surgeons’ Use of Perioperative Breast Magnetic Resonance Imaging
Shi Y, Pollack CE, Soulos PR, Herrin J, Christakis NA, Xu X, Gross CP. Association Between Degrees of Separation in Physician Networks and Surgeons’ Use of Perioperative Breast Magnetic Resonance Imaging. Medical Care 2019, 57: 460-467. PMID: 31008899, PMCID: PMC6522278, DOI: 10.1097/mlr.0000000000001123.Peer-Reviewed Original ResearchConceptsBreast magnetic resonance imagingMagnetic resonance imagingPerioperative magnetic resonance imagingMRI useResonance imagingSurgeons' useBreast cancer carePatient-sharing networksPractice of surgeonsPairs of surgeonsUnproven benefitRetrospective studyPhysician pairsCancer carePractice patternsBreast cancerMRI utilizationMedicare dataSurgical colleaguesPatientsSurgeonsStudy periodPhysician networksCareAssociationPersistent Use of Extended Fractionation Palliative Radiotherapy for Medicare Beneficiaries With Metastatic Breast Cancer, 2011 to 2014
Yu JB, Pollack CE, Herrin J, Zhu W, Soulos PR, Xu X, Gross CP. Persistent Use of Extended Fractionation Palliative Radiotherapy for Medicare Beneficiaries With Metastatic Breast Cancer, 2011 to 2014. American Journal Of Clinical Oncology 2019, 42: 493-499. PMID: 31033511, PMCID: PMC6538429, DOI: 10.1097/coc.0000000000000548.Peer-Reviewed Original ResearchConceptsPalliative radiotherapyBone metastasesMedicare beneficiariesBreast cancerAssociation of clinicalProportion of patientsChoice of treatmentHospital-based practiceService Medicare beneficiariesSingle-fraction treatmentProvider financial incentivesLogistic regression modelsDifferent fractionation schemesProlonged courseRadiation courseRadiotherapy usePayer perspectiveProvider characteristicsMean costMultiple guidelinesPatientsRadiotherapyMetastasisCancerNumber of daysRisk of Gastrointestinal Bleeding Increases With Combinations of Antithrombotic Agents and Patient Age
Abraham NS, Noseworthy PA, Inselman J, Herrin J, Yao X, Sangaralingham LR, Cornish G, Ngufor C, Shah ND. Risk of Gastrointestinal Bleeding Increases With Combinations of Antithrombotic Agents and Patient Age. Clinical Gastroenterology And Hepatology 2019, 18: 337-346.e19. PMID: 31108228, PMCID: PMC7386161, DOI: 10.1016/j.cgh.2019.05.017.Peer-Reviewed Original ResearchConceptsGastrointestinal bleedingAntiplatelet monotherapyGIB riskAntiplatelet agentsRisk of GIBCombination antithrombotic therapyDifferent antithrombotic regimensDifferent antithrombotic strategiesDrug exposure categoriesProportion of patientsNationwide claims dataMedicare Advantage enrolleesAntithrombotic regimensBleeding increasesAntithrombotic therapyAntithrombotic strategiesElderly patientsCombination regimensPatient ageCombination therapyPrimary diagnosisAntithrombotic drugsAntithrombotic agentsCardiovascular conditionsRetrospective analysisDifferential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery
Hoag JR, Resio BJ, Monsalve AF, Chiu AS, Brown LB, Herrin J, Blasberg JD, Kim AW, Boffa DJ. Differential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery. JAMA Network Open 2019, 2: e191912. PMID: 30977848, PMCID: PMC6481444, DOI: 10.1001/jamanetworkopen.2019.1912.Peer-Reviewed Original ResearchConceptsComplex cancer surgeryCancer surgeryCancer HospitalMedicare beneficiariesCancer NetworkRelative safetyStandardized mortality ratioComplex cancer careCross-sectional studyTop-ranked hospitalsMedicaid Services 100Hierarchical logistic regressionPerioperative mortalityAffiliated HospitalCancer careMortality ratioOdds ratioMAIN OUTCOMESurgeryHospitalReview filesDifferential safetyLogistic regressionMortalityMedicare providersRisk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study
Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. Journal Of The American Medical Directors Association 2019, 20: 432-437. PMID: 30954133, PMCID: PMC6486375, DOI: 10.1016/j.jamda.2019.01.135.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesSNF dischargeRetrospective cohort studySNF lengthHeart failureHF hospitalizationComposite outcomeCohort studyNursing facilitiesService beneficiaries 65Heart failure hospitalizationRisk of readmissionHazard rate ratiosFailure hospitalizationUnplanned readmissionHF diagnosisHospital dischargePostdischarge outcomesSNF stayMedicare patientsMedicare feeHome transitionPatientsReadmissionDay 3Trends in Hospital Readmission of Medicare-Covered Patients With Heart Failure
Blecker S, Herrin J, Li L, Yu H, Grady JN, Horwitz LI. Trends in Hospital Readmission of Medicare-Covered Patients With Heart Failure. Journal Of The American College Of Cardiology 2019, 73: 1004-1012. PMID: 30846093, PMCID: PMC7011858, DOI: 10.1016/j.jacc.2018.12.040.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramSecondary heart failureReadmission ratesHeart failureReadmissions Reduction ProgramHF hospitalizationAffordable Care ActMedicare's Hospital Readmissions Reduction ProgramRisk-adjusted readmission ratesCause readmission rateHigher readmission ratesAcute myocardial infarctionCare ActReduction programsLinear spline regression modelsPneumonia hospitalizationsHospital readmissionMedicare hospitalizationsRetrospective studySecondary diagnosisMyocardial infarctionPrincipal diagnosisHospitalizationSpline regression modelsPatientsMeasuring hospital‐specific disparities by dual eligibility and race to reduce health inequities
Lloren A, Liu S, Herrin J, Lin Z, Zhou G, Wang Y, Kuang M, Zhou S, Farietta T, McCole K, Charania S, Sheares K, Bernheim S. Measuring hospital‐specific disparities by dual eligibility and race to reduce health inequities. Health Services Research 2019, 54: 243-254. PMID: 30666634, PMCID: PMC6341208, DOI: 10.1111/1475-6773.13108.Peer-Reviewed Original ResearchConceptsAfrican American racePatient case mixDual eligibilityReadmission ratesAmerican raceRisk-standardized outcomesHigher readmission ratesDual eligibility statusAcute myocardial infarctionAfrican American patientsRisk-standardized readmission ratesAcute care hospitalsQuality of careMedicaid Services methodologyHealth care qualityHospital disparitiesCare hospitalHeart failureInpatient admissionsMyocardial infarctionAmerican patientsMedicare patientsCase mixHealth outcomesHospital
2018
An empiric approach to identifying physician peer groups from claims data: An example from breast cancer care
Herrin J, Soulos PR, Xu X, Gross CP, Pollack CE. An empiric approach to identifying physician peer groups from claims data: An example from breast cancer care. Health Services Research 2018, 54: 44-51. PMID: 30488484, PMCID: PMC6338298, DOI: 10.1111/1475-6773.13095.Peer-Reviewed Original ResearchConceptsPhysician peer groupsClaims dataEnd Results-MedicareBreast cancer careAdministrative claims dataHospital-based groupEmpiric approachCancer careBreast cancerHospital groupPatientsPatient volumePhysiciansEmpirical groupGroup reliabilityPhysician inclusionPercentGroupMedian overlapT1CancerPeer groupEpidemiologySurgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI
Tannenbaum SS, Soulos PR, Herrin J, Pollack CE, Xu X, Christakis NA, Forman HP, Yu JB, Killelea BK, Wang S, Gross CP. Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI. Cancer Medicine 2018, 7: 5901-5909. PMID: 30444005, PMCID: PMC6308117, DOI: 10.1002/cam4.1821.Peer-Reviewed Original ResearchConceptsPrimary care physiciansPatient-sharing networksBreast cancerPerioperative MRISubsequent receiptNon-cancer patientsBreast cancer practiceMultivariable hierarchical modelsUse of MRIClinical characteristicsCare physiciansFemale patientsCancer practiceMedicare databaseNew imaging techniquesMedicare sampleStage 0Claims dataPatientsPhysician groupsMRISurgeonsCancerEquivocal evidencePhysiciansAssociation of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older
Riley C, Roy B, Herrin J, Spatz ES, Arora A, Kell KP, Rula EY, Krumholz HM. Association of the Overall Well-being of a Population With Health Care Spending for People 65 Years of Age or Older. JAMA Network Open 2018, 1: e182136. PMID: 30646154, PMCID: PMC6324481, DOI: 10.1001/jamanetworkopen.2018.2136.Peer-Reviewed Original ResearchConceptsMedicare FFS beneficiariesPeople 65 yearsHealth care spendingFFS beneficiariesCare spendingPopulation-based cross-sectional studyLower health care spendingHealth care system capacityCross-sectional studyHealth care systemPopulation levelPayment modelsCare payment modelsHighest quintileInverse associationStudy interventionMAIN OUTCOMEMedicare feeMedicare beneficiariesUS national studyOverall healthMedian household incomeBeing IndexCare systemDemographic characteristics