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The Centers for Medicare & Medicaid Services (CMS) readmission measure is based on all-cause readmissions to any hospital within 30 days of discharge. Whether a measure based on same-hospital readmission, an outcome that is easier for hospitals and some systems to track, could serve as a proxy for the all-hospital measure is not known.

Prior research identified variations in care experiences across Medicare health plans (Medicare Advantage MA), but the relative amount of variation in MA and traditional fee-for-service (FFS) Medicare is unknown.

In July 2009, Medicare began publicly reporting hospitals' risk-standardized 30-day all-cause readmission rates (RSRRs) among fee-for-service beneficiaries discharged after hospitalization for heart failure from all the US acute care nonfederal hospitals. No recent national trends in RSRRs have been reported, and it is not known whether hospital-specific performance is improving or variation in performance is decreasing.

The rankings of “America’s Best Hospitals” by U.S.News & World Reportare influential, but the performance of ranked hospitals in caring for patients with routine cardiac conditions such as heart failure is not known.

The Centers for Medicare & Medicaid Services pays for services provided through traditional fee-for-service (FFS) Medicare and managed care plans (Medicare Advantage MA). It is important to understand how financing and organizational arrangements relate to quality of care.

Use of more than one health care system to obtain care is common among adults receiving care within the Veterans Affairs (VA) medical system. It is not known what effect using care from multiple sources has on the quality of care patients receive.