2024
Incorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure
Kyanko K, Sahay K, Wang Y, Li S, Schreiber M, Hager M, Myers R, Johnson W, Zhang J, Krumholz H, Suter L, Triche E. Incorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure. JAMA Network Open 2024, 7: e2414431. PMID: 38829614, PMCID: PMC11148674, DOI: 10.1001/jamanetworkopen.2024.14431.Peer-Reviewed Original ResearchConceptsCenters for Medicare & Medicaid ServicesSpecialty subgroupsPerformance quintileMedicare AdvantageReadmission ratesRisk-standardized readmission ratesHospital-wide readmission measureHospital outcome measuresTest-retest reliabilityRisk-adjustment variablesMeasurement reliabilityAdministrative claims dataReadmission measuresImprove measurement reliabilityIntegrated data repositoryMA beneficiariesQuintile rankingsMedicare beneficiariesMedicaid ServicesAll-causePublic reportingStudy assessed differencesClaims dataOutcome measuresMA cohort
2021
Administrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery
Mori M, Nasir K, Bao H, Jimenez A, Legore SS, Wang Y, Grady J, Lama SD, Brandi N, Lin Z, Kurlansky P, Geirsson A, Bernheim SM, Krumholz HM, Suter LG. Administrative Claims Measure for Profiling Hospital Performance Based on 90-Day All-Cause Mortality Following Coronary Artery Bypass Graft Surgery. Circulation Cardiovascular Quality And Outcomes 2021, 14: e006644. PMID: 33535776, DOI: 10.1161/circoutcomes.120.006644.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesCoronary artery bypass graft surgeryArtery bypass graft surgeryBypass graft surgeryMortality rateGraft surgeryC-statisticMedicaid ServicesAdministrative Claims MeasureCause mortality ratesMortality measuresUnadjusted mortality ratesProfiling Hospital PerformanceHierarchical logistic regression modelsAlternate payment modelsHospital performanceLogistic regression modelsCABG recoveryPayment modelsCABG surgeryCause mortalityCABG proceduresDays postsurgeryHospital levelSurgery
2020
Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults
Mori M, Wang Y, Mahajan S, Geirsson A, Krumholz HM. Associations Between the Severity of Influenza Seasons and Mortality and Readmission Risks After Elective Surgical Aortic Valve Replacement and Coronary Artery Bypass Graft Surgery in Older Adults. JAMA Network Open 2020, 3: e2031078. PMID: 33355673, PMCID: PMC7758803, DOI: 10.1001/jamanetworkopen.2020.31078.Peer-Reviewed Original ResearchConceptsSurgical aortic valve replacementElective surgical aortic valve replacementAortic valve replacementValve replacementReadmission riskCoronary artery bypass graft surgeryArtery bypass graft surgeryOlder adultsBypass graft surgeryCoronary artery bypassCross-sectional studyArtery bypassGraft surgeryInfluenza seasonMedicaid ServicesMortalitySeverityAdultsRiskAssociationSurgeryBypass
2017
Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization
Schwartz J, Wang Y, Qin L, Schwamm LH, Fonarow GC, Cormier N, Dorsey K, McNamara RL, Suter LG, Krumholz HM, Bernheim SM. Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization. Stroke 2017, 48: 3101-3107. PMID: 28954922, DOI: 10.1161/strokeaha.117.017960.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesElectronic health record dataHealth record dataStroke severityClaims dataMortality rateAmerican Heart Association/American Stroke AssociationHealth Stroke Scale scoreRisk variablesMedicaid ServicesRisk adjustmentMedian risk-standardized mortality rateGuidelines-Stroke registryLow-mortality hospitalsStroke Scale scoreAcute ischemic strokeAmerican Stroke AssociationOdds of mortalityMortality measuresRecord dataIschemic stroke hospitalizationsHigh-mortality hospitalsService claims dataRisk-adjustment variablesHospital admission
2016
Community-Level Association Between Home Health and Nursing Home Performance on Quality and Hospital 30-Day Readmissions for Medicare Patients
Wang Y, Pandolfi MM, Fine J, Metersky ML, Wang C, Ho SY, Galusha D, Nuti SV, Murugiah K, Spenard A, Elwell T, Krumholz HM. Community-Level Association Between Home Health and Nursing Home Performance on Quality and Hospital 30-Day Readmissions for Medicare Patients. Home Health Care Management & Practice 2016, 28: 201-208. PMID: 27974869, PMCID: PMC5152769, DOI: 10.1177/1084822316639032.Peer-Reviewed Original ResearchRisk-standardized readmission ratesHome health agenciesReadmission ratesMedicare patientsHealth agenciesCommunity level hospitalCommunity-level associationsNursing home performanceHome healthNursing homesPatientsMedicaid ServicesHospitalMixed effects modelsHealth performanceEffects modelHome performanceFinal sampleReadmission
2015
An Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction
Kim N, Bernheim SM, Ott LS, Han L, Spivack SB, Xu X, Volpe M, Liu A, Krumholz HM. An Administrative Claims Measure of Payments Made for Medicare Patients for a 30-Day Episode of Care for Acute Myocardial Infarction. Medical Care 2015, 53: 542-549. PMID: 25970575, DOI: 10.1097/mlr.0000000000000361.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionMyocardial infarctionICD-9 codes 410Administrative Claims MeasurePatients 65 yearsDate of admissionClaims-based measuresIntraclass correlation coefficient scoreIntraclass correlation coefficientValue of careHigh-value careClinical variablesDischarge diagnosisMedicare patientsMedicare claimsClinical careAMI episodeAMI hospitalizationCare costsCode 410HospitalizationMedicaid ServicesHospitalClaims measuresCare
2014
Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission.
Horwitz LI, Partovian C, Lin Z, Grady JN, Herrin J, Conover M, Montague J, Dillaway C, Bartczak K, Suter LG, Ross JS, Bernheim SM, Krumholz HM, Drye EE. Development and use of an administrative claims measure for profiling hospital-wide performance on 30-day unplanned readmission. Annals Of Internal Medicine 2014, 161: s66-75. PMID: 25402406, PMCID: PMC4235629, DOI: 10.7326/m13-3000.Peer-Reviewed Original ResearchConceptsUnplanned readmissionReadmission measuresReadmission ratesReadmission riskMedicare feeHospital-wide readmission measureRisk-standardized readmission ratesPayer dataAdministrative Claims MeasureRisk-standardized ratesAverage-risk patientsUnplanned readmission rateDays of dischargeHospital risk-standardized readmission ratesAdult hospitalizationsComorbid conditionsPrincipal diagnosisClaims dataService claimsService beneficiariesReadmissionMeasure development studiesMedicaid ServicesRisk adjustmentHospitalNational Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release
Suter LG, Li SX, Grady JN, Lin Z, Wang Y, Bhat KR, Turkmani D, Spivack SB, Lindenauer PK, Merrill AR, Drye EE, Krumholz HM, Bernheim SM. National Patterns of Risk-Standardized Mortality and Readmission After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia: Update on Publicly Reported Outcomes Measures Based on the 2013 Release. Journal Of General Internal Medicine 2014, 29: 1333-1340. PMID: 24825244, PMCID: PMC4175654, DOI: 10.1007/s11606-014-2862-5.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionHeart failurePneumonia mortalityMyocardial infarctionMedian risk-standardized mortality rateHospital-level mortalityUnplanned readmission ratePrincipal discharge diagnosisHospital performanceRisk-Standardized MortalityHF mortalityReadmission resultsReadmission ratesDischarge diagnosisOutcome measuresAMI mortalityReadmission measuresPneumoniaMortality rateService MedicareHierarchical logistic modelsMortalityMedicaid ServicesReadmission
2013
Trends in Intracranial Stenting Among Medicare Beneficiaries in the United States, 2006–2010
Gupta A, Desai MM, Kim N, Bulsara KR, Wang Y, Krumholz HM. Trends in Intracranial Stenting Among Medicare Beneficiaries in the United States, 2006–2010. Journal Of The American Heart Association 2013, 2: e000084. PMID: 23588099, PMCID: PMC3647283, DOI: 10.1161/jaha.113.000084.Peer-Reviewed Original ResearchConceptsIntracranial stentingMortality rateService beneficiariesICD-9-CM procedure codesPrincipal discharge diagnosis codeOverall hospitalization rateDischarge diagnosis codesHumanitarian Device Exemption approvalAcute care hospitalsHumanitarian Device ExemptionCare hospitalIntracranial angioplastyHospitalization ratesICS useSubarachnoid hemorrhageDiagnosis codesOperative rateProcedure ratesMedicare feeMedicare beneficiariesInsufficient evidenceICS procedureDrug AdministrationCerebral aneurysmsMedicaid ServicesRelationship Between Hospital Readmission and Mortality Rates for Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia
Krumholz HM, Lin Z, Keenan PS, Chen J, Ross JS, Drye EE, Bernheim SM, Wang Y, Bradley EH, Han LF, Normand SL. Relationship Between Hospital Readmission and Mortality Rates for Patients Hospitalized With Acute Myocardial Infarction, Heart Failure, or Pneumonia. JAMA 2013, 309: 587-593. PMID: 23403683, PMCID: PMC3621028, DOI: 10.1001/jama.2013.333.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionRisk-standardized readmission ratesHospital risk-standardized mortality ratesHeart failureMyocardial infarctionHospital characteristicsMortality rateReadmission ratesProportion of hospitalsHospital readmissionMedicare feePneumoniaInfarctionService beneficiariesHospitalPatientsMedicaid ServicesHospital performanceSubgroupsFailureCauseReadmissionSignificant negative linear relationship
2012
Regional Associations Between Medicare Advantage Penetration and Administrative Claims-based Measures of Hospital Outcomes
Kulkarni VT, Shah SJ, Bernheim SM, Wang Y, Normand SL, Han LF, Rapp MT, Drye EE, Krumholz HM. Regional Associations Between Medicare Advantage Penetration and Administrative Claims-based Measures of Hospital Outcomes. Medical Care 2012, 50: 406-409. PMID: 22456113, PMCID: PMC5459365, DOI: 10.1097/mlr.0b013e318245a0f9.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionRisk-standardized readmission ratesHospital outcomesReadmission ratesHeart failureMyocardial infarctionPopulation riskOutcome measuresMortality rateMedicare Advantage patientsHospital referral region levelHospital outcome measuresClaims-based measuresMedicaid Services measuresFFS patientsAdvantage patientsRetrospective studyService patientsMedicare feeMedicare Advantage penetrationPatientsMedicaid ServicesInfarctionPneumonia
2011
National Performance on Door-In to Door-Out Time Among Patients Transferred for Primary Percutaneous Coronary Intervention
Herrin J, Miller LE, Turkmani DF, Nsa W, Drye EE, Bernheim SM, Ling SM, Rapp MT, Han LF, Bratzler DW, Bradley EH, Nallamothu BK, Ting HH, Krumholz HM. National Performance on Door-In to Door-Out Time Among Patients Transferred for Primary Percutaneous Coronary Intervention. JAMA Internal Medicine 2011, 171: 1879-1886. PMID: 22123793, PMCID: PMC4312661, DOI: 10.1001/archinternmed.2011.481.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionDIDO timeCoronary interventionST-segment elevation acute myocardial infarctionMixed-effects multivariable modelElevation acute myocardial infarctionPrimary percutaneous coronary interventionMedian DIDO timeAcute myocardial infarctionFibrinolytic therapyPatient characteristicsMultivariable analysisEmergency departmentMyocardial infarctionHospital characteristicsMultivariable modelPatientsRural hospitalsHospitalMedicaid ServicesAge categoriesInterventionAfrican AmericansMinutesTreatment timeImprovements in Door-to-Balloon Time in the United States, 2005 to 2010
Krumholz HM, Herrin J, Miller LE, Drye EE, Ling SM, Han LF, Rapp MT, Bradley EH, Nallamothu BK, Nsa W, Bratzler DW, Curtis JP. Improvements in Door-to-Balloon Time in the United States, 2005 to 2010. Circulation 2011, 124: 1038-1045. PMID: 21859971, PMCID: PMC3598634, DOI: 10.1161/circulationaha.111.044107.Peer-Reviewed Original ResearchConceptsPrimary percutaneous coronary interventionPercutaneous coronary interventionBalloon timeCoronary interventionMedian timeST-segment elevation myocardial infarctionHigher median timeCharacteristics of patientsPercentage of patientsTimeliness of treatmentYears of ageRegistry studyMyocardial infarctionInpatient measuresPatientsHospital groupMedicaid ServicesCalendar yearInterventionMinutesMedianGroupYearsPercentageInfarction
2010
Who is missing from the measures? Trends in the proportion and treatment of patients potentially excluded from publicly reported quality measures
Bernheim SM, Wang Y, Bradley EH, Masoudi FA, Rathore SS, Ross JS, Drye E, Krumholz HM. Who is missing from the measures? Trends in the proportion and treatment of patients potentially excluded from publicly reported quality measures. American Heart Journal 2010, 160: 943-950.e5. PMID: 21095284, PMCID: PMC3319386, DOI: 10.1016/j.ahj.2010.06.046.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAngiotensin-Converting Enzyme InhibitorsCross-Sectional StudiesFemaleHospitalizationHumansMaleMedicaidMedicareMyocardial InfarctionOutcome and Process Assessment, Health CarePlatelet Aggregation InhibitorsPrognosisQuality ImprovementQuality Indicators, Health CareRetrospective StudiesUnited StatesConceptsAcute myocardial infarctionProportion of patientsRelative contraindicationAngiotensin-converting enzyme inhibitorTreatment of patientsMedicaid Services core measuresQuality improvement projectPublic reportingCross-sectional analysisMyocardial infarctionMedicare patientsHospital careΒ-blockersAMI admissionsPatientsInsufficient evidenceEnzyme inhibitorsTreatment ratesBetter careContraindicationsMedicaid ServicesData cohortCore measuresTreatmentImprovement project
2009
Patterns of Hospital Performance in Acute Myocardial Infarction and Heart Failure 30-Day Mortality and Readmission
Krumholz HM, Merrill AR, Schone EM, Schreiner GC, Chen J, Bradley EH, Wang Y, Wang Y, Lin Z, Straube BM, Rapp MT, Normand SL, Drye EE. Patterns of Hospital Performance in Acute Myocardial Infarction and Heart Failure 30-Day Mortality and Readmission. Circulation Cardiovascular Quality And Outcomes 2009, 2: 407-413. PMID: 20031870, DOI: 10.1161/circoutcomes.109.883256.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failureReadmission ratesMyocardial infarctionMortality rateRisk-standardized mortality ratesAge 65 yearsRisk-standardized mortalityHospital referral regionsHospital structural characteristicsType of hospitalHospital performancePrimary diagnosisHospital characteristicsReferral regionsMedicare feeMortalityMedicaid ServicesInfarctionHospitalGeographic differencesReadmissionFailureDiagnosis
2007
Measuring Performance For Treating Heart Attacks And Heart Failure: The Case For Outcomes Measurement
Krumholz HM, Normand SL, Spertus JA, Shahian DM, Bradley EH. Measuring Performance For Treating Heart Attacks And Heart Failure: The Case For Outcomes Measurement. Health Affairs 2007, 26: 75-85. PMID: 17211016, DOI: 10.1377/hlthaff.26.1.75.Peer-Reviewed Original Research
2006
Strategies for Reducing the Door-to-Balloon Time in Acute Myocardial Infarction
Bradley EH, Herrin J, Wang Y, Barton BA, Webster TR, Mattera JA, Roumanis SA, Curtis JP, Nallamothu BK, Magid DJ, McNamara RL, Parkosewich J, Loeb JM, Krumholz HM. Strategies for Reducing the Door-to-Balloon Time in Acute Myocardial Infarction. New England Journal Of Medicine 2006, 355: 2308-2320. PMID: 17101617, DOI: 10.1056/nejmsa063117.Peer-Reviewed Original ResearchConceptsST-segment elevationBalloon timeCatheterization laboratoryMyocardial infarctionFaster doorEmergency departmentPrimary percutaneous coronary interventionHospital strategiesIntracoronary balloon inflationPercutaneous coronary interventionAcute myocardial infarctionMinority of hospitalsEmergency medicine physiciansReperfusion treatmentCoronary interventionBalloon inflationMedicine physiciansMultivariate analysisHospitalInfarctionPatientsMedicaid ServicesSignificant reductionReal-time data feedbackData feedbackHospital Quality for Acute Myocardial Infarction: Correlation Among Process Measures and Relationship With Short-term Mortality
Bradley EH, Herrin J, Elbel B, McNamara RL, Magid DJ, Nallamothu BK, Wang Y, Normand SL, Spertus JA, Krumholz HM. Hospital Quality for Acute Myocardial Infarction: Correlation Among Process Measures and Relationship With Short-term Mortality. JAMA 2006, 296: 72-78. PMID: 16820549, DOI: 10.1001/jama.296.1.72.Peer-Reviewed Original ResearchMeSH KeywordsAgedCenters for Medicare and Medicaid Services, U.S.Cross-Sectional StudiesHospital MortalityHospitalsHumansJoint Commission on Accreditation of Healthcare OrganizationsMedicareMyocardial InfarctionOutcome and Process Assessment, Health CareQuality Indicators, Health CareRegistriesRisk AssessmentUnited StatesConceptsAcute myocardial infarctionMortality rateMyocardial infarctionProcess measuresAngiotensin-converting enzyme inhibitor useRisk-standardized mortality ratesShort-term mortality rateBeta-blocker useEnzyme inhibitor useHospital performanceHospital-level variationShort-term mortalityQuality process measuresAspirin useCessation counselingHospital outcomesInhibitor useAMI patientsNational registryMedication measuresTherapy measuresHospital qualityInfarctionMedicaid ServicesJoint Commission
2001
Lessons Learned From the National Heart Failure Project: A Center for Medicare & Medicaid Services Initiative to Improve the Care of Medicare Beneficiaries With Heart Failure
Havranek E, Masoudi F, Smith G, Wolfe P, Ralston D, Krumholz H, Ordin D. Lessons Learned From the National Heart Failure Project: A Center for Medicare & Medicaid Services Initiative to Improve the Care of Medicare Beneficiaries With Heart Failure. Congestive Heart Failure 2001, 7: 334-336. PMID: 11828183, DOI: 10.1111/j.1527-5299.2001.00273.x.Peer-Reviewed Original ResearchNational Heart Failure ProjectHeart Failure ProjectQuality improvement effortsHeart failureMedicare beneficiariesQuality indicator dataEnzyme inhibitor prescriptionQuality indicator ratesQuality improvement projectHealth Care Financing AdministrationFuture quality improvementMedicaid Services InitiativeInhibitor prescriptionPeer review organizationsImprovement effortsPhysician's officeInpatient feeIndicator ratesMedicaid ServicesFailure ProjectHospitalImprovement projectCareMedicareFailure