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
2019
Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data
Krumholz HM, Warner F, Coppi A, Triche EW, Li SX, Mahajan S, Li Y, Bernheim SM, Grady J, Dorsey K, Desai NR, Lin Z, Normand ST. Development and Testing of Improved Models to Predict Payment Using Centers for Medicare & Medicaid Services Claims Data. JAMA Network Open 2019, 2: e198406. PMID: 31411709, PMCID: PMC6694388, DOI: 10.1001/jamanetworkopen.2019.8406.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionHeart failurePopulation-based programsPOA codesSingle diagnostic codeDiagnostic codesComparative effectiveness research studyPublic reportingIndex admission diagnosisDays of hospitalizationClinical Modification codesService claims dataAcute care hospitalsMultiple care settingsPatient-level modelsAdmission diagnosisTotal hospitalizationsCare hospitalPrevious diagnosisNinth RevisionMyocardial infarctionCandidate variablesCare settingsClaims dataMAIN OUTCOME
2015
Development and Validation of an Algorithm to Identify Planned Readmissions From Claims Data
Horwitz LI, Grady JN, Cohen DB, Lin Z, Volpe M, Ngo CK, Masica AL, Long T, Wang J, Keenan M, Montague J, Suter LG, Ross JS, Drye EE, Krumholz HM, Bernheim SM. Development and Validation of an Algorithm to Identify Planned Readmissions From Claims Data. Journal Of Hospital Medicine 2015, 10: 670-677. PMID: 26149225, PMCID: PMC5459369, DOI: 10.1002/jhm.2416.Peer-Reviewed Original ResearchConceptsSame-hospital readmissionsNegative predictive valuePositive predictive valuePredictive valueReadmission measuresHospital-wide readmission measureGold standard chart reviewAdministrative claims-based algorithmDiagnostic cardiac catheterizationClaims-based algorithmLarge teaching centersAcute care hospitalsSmall community hospitalUnplanned readmissionChart reviewCardiac catheterizationScheduled careSpecificity 96.5Community hospitalReadmissionClaims dataCardiac devicesHealth systemTeaching centerPublic reporting
2013
Association Between a Hospital’s Quality Performance for In-Hospital Cardiac Arrest and Common Medical Conditions
Chen LM, Nallamothu BK, Krumholz HM, Spertus JA, Tang F, Chan PS. Association Between a Hospital’s Quality Performance for In-Hospital Cardiac Arrest and Common Medical Conditions. Circulation Cardiovascular Quality And Outcomes 2013, 6: 700-707. PMID: 24221831, PMCID: PMC4465597, DOI: 10.1161/circoutcomes.113.000377.Peer-Reviewed Original ResearchConceptsCommon medical conditionsHospital survival rateAcute myocardial infarctionCardiac arrestMedical conditionsSurvival rateInpatient survivalHeart failureMyocardial infarctionMortality rateHospital cardiac arrest registryHospital qualityIn-Hospital Cardiac ArrestRisk-standardized mortality ratesCardiac Arrest RegistryCardiac arrest outcomesCardiac arrest patientsHospital cardiac arrestCardiac arrest survival ratesPublic reportingHospital outcomesArrest patientsHospital CompareArrest outcomesHospital
2011
Public reporting of hospital outcomes: a challenging road ahead
Gallagher MP, Krumholz HM. Public reporting of hospital outcomes: a challenging road ahead. The Medical Journal Of Australia 2011, 194: 658-660. PMID: 21692729, DOI: 10.5694/j.1326-5377.2011.tb03156.x.Peer-Reviewed Original Research
2010
State-Sponsored Public Reporting Of Hospital Quality: Results Are Hard To Find And Lack Uniformity
Ross JS, Sheth S, Krumholz HM. State-Sponsored Public Reporting Of Hospital Quality: Results Are Hard To Find And Lack Uniformity. Health Affairs 2010, 29: 2317-2322. PMID: 21134936, PMCID: PMC3020979, DOI: 10.1377/hlthaff.2010.0564.Peer-Reviewed Original ResearchWho 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
2008
Public Reporting of 30-Day Mortality for Patients Hospitalized With Acute Myocardial Infarction and Heart Failure
Krumholz HM, Normand SL. Public Reporting of 30-Day Mortality for Patients Hospitalized With Acute Myocardial Infarction and Heart Failure. Circulation 2008, 118: 1394-1397. PMID: 18725492, DOI: 10.1161/circulationaha.108.804880.Peer-Reviewed Original Research
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