2021
Incorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models
Triche EW, Xin X, Stackland S, Purvis D, Harris A, Yu H, Grady JN, Li SX, Bernheim SM, Krumholz HM, Poyer J, Dorsey K. Incorporating Present-on-Admission Indicators in Medicare Claims to Inform Hospital Quality Measure Risk Adjustment Models. JAMA Network Open 2021, 4: e218512. PMID: 33978722, PMCID: PMC8116982, DOI: 10.1001/jamanetworkopen.2021.8512.Peer-Reviewed Original ResearchConceptsPOA indicatorRisk factorsOutcome measuresQuality outcome measuresRisk-adjustment modelsClaims dataAdmission indicatorsPatient risk factorsAcute myocardial infarctionPatient-level outcomesAdministrative claims dataQuality improvement studyClaims-based measuresComparative effectiveness studiesPatient claims dataInternational Statistical ClassificationMortality outcome measuresRelated Health ProblemsHospital quality measuresRisk model performanceHospital stayIndex admissionCare algorithmHeart failureMortality outcomes
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
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