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
2016
Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates
Bernheim SM, Parzynski CS, Horwitz L, Lin Z, Araas MJ, Ross JS, Drye EE, Suter LG, Normand SL, Krumholz HM. Accounting For Patients’ Socioeconomic Status Does Not Change Hospital Readmission Rates. Health Affairs 2016, 35: 1461-1470. PMID: 27503972, PMCID: PMC7664840, DOI: 10.1377/hlthaff.2015.0394.Peer-Reviewed Original ResearchConceptsHospital Readmissions Reduction ProgramPatients' socioeconomic statusMedicare's Hospital Readmissions Reduction ProgramLow socioeconomic statusReadmission ratesSocioeconomic statusRisk-standardized readmission ratesHospital readmission ratesReadmissions Reduction ProgramMedicaid Services methodologyReadmission measuresHospital resultsPatientsHospitalSuch hospitalsPayment penaltiesReduction programsStatusCurrent CentersLower proportionLarge proportionPercentAdjustmentProportion
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
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
2012
Correlations among risk‐standardized mortality rates and among risk‐standardized readmission rates within hospitals
Horwitz LI, Wang Y, Desai MM, Curry LA, Bradley EH, Drye EE, Krumholz HM. Correlations among risk‐standardized mortality rates and among risk‐standardized readmission rates within hospitals. Journal Of Hospital Medicine 2012, 7: 690-696. PMID: 22865546, PMCID: PMC3535010, DOI: 10.1002/jhm.1965.Peer-Reviewed Original ResearchConceptsRisk-standardized mortality ratesAcute myocardial infarctionRisk-standardized readmission ratesReadmission ratesRisk-standardized mortalityHeart failureMortality rateReadmission measuresUS hospitalsMortality measuresCross-sectional studyMortality cohortReadmission cohortHospital outcomesSame hospitalMyocardial infarctionMedicare patientsMedicare feeService beneficiariesTeaching hospital membersHospitalSame quartileHospital membersPneumoniaCohortHospitalist utilization and hospital performance on 6 publicly reported patient outcomes
Goodrich K, Krumholz HM, Conway PH, Lindenauer P, Auerbach AD. Hospitalist utilization and hospital performance on 6 publicly reported patient outcomes. Journal Of Hospital Medicine 2012, 7: 482-488. PMID: 22689448, PMCID: PMC3531241, DOI: 10.1002/jhm.1943.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionPercentage of patientsHeart failurePatient outcomesOutcome measuresPresence of hospitalistsReadmission measuresCongestive heart failureCross-sectional studyMultivariable regression modelsComparison of hospitalQuality outcome measuresReadmission ratesIndependent predictorsMyocardial infarctionInpatient careHospitalist serviceHospitalist useMedical conditionsHospital personnelHospitalist programHospitalistsHospitalExpectation of improvementOutcomes
2010
Is Same-Hospital Readmission Rate a Good Surrogate for All-Hospital Readmission Rate?
Nasir K, Lin Z, Bueno H, Normand SL, Drye EE, Keenan PS, Krumholz HM. Is Same-Hospital Readmission Rate a Good Surrogate for All-Hospital Readmission Rate? Medical Care 2010, 48: 477-481. PMID: 20393366, DOI: 10.1097/mlr.0b013e3181d5fb24.Peer-Reviewed Original ResearchConceptsRisk-standardized readmission ratesHospital readmission ratesSame-hospital readmissionsSame-hospital readmission ratesDays of dischargeReadmission ratesHeart failureUS acute care hospitalsThirty-day readmissionStandard Analytic FilesAcute care hospitalsHierarchical logistic regression modelsLogistic regression modelsCause readmissionHF readmissionIndex hospitalizationCare hospitalHospital readmissionAnalytic FilesMedicare inpatientReadmissionStudy populationHospital measuresReadmission measuresHospitalization