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RAFF: Samson Oleh Tokar (Delilah), Magnus Vigilius (Samson), Robin Adams (Abimelech), Christian Immler (High Priest), Michael Weinius (Micha); Bern Symphony & Chorus/ Philippe Bach Suisa 91357 [3CD] 184 minutes Die [...]

Objective: To examine changes in hospitalization trends and healthcare utilization among Veterans following Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act implementation. Data Sources and Study Setting: VA Corporate Data Warehouse and Centers for Medicare and Medicaid Services datasets. Study Design: Retrospective cohort study to compare 7- and 30-day rates for unplanned readmission and emergency department visits following index hospital stays based on payor type (VHA facility stay, VA-funded stay in community facility [CC], or Medicare-funded community stay [CMS]). Segmented regression models were used to compare payors and estimate changes in outcome levels and slopes following MISSION Act implementation. Data Collection/Extraction Methods: Veterans with active VA primary care utilization and [greater than or equal to]1 acute hospitalization between January 1, 2016 and December 31, 2021. Principal Findings: Monthly index stays increased for all payors until MISSION Act implementation, when VHA and CMS admissions declined while CC admissions accelerated and overtook VHA admissions. In December 2021, CC admissions accounted for 54% of index admissions, up from 25% in January 2016. From adjusted models, just prior to implementation (May 2019), Veterans with CC admissions had 47% greater risk of 7-day readmission (risk ratio [RR]: 1.47, 95% confidence interval [CI]: 1.43,1.51) and 20% greater risk of 30-day readmission (RR: 1.20, 95% CI: 1.19,1.22) compared with those with VHA admissions; both effects persisted postimplementation. Pre-implementation CC admissions were also associated with higher 7- and 30-day ED visits, but both risks were substantially lower by study termination (RR: 0.90, 95% CI: 0.88, 0.91) and (RR: 0.89, 95% CI: 0.87, 0.90), respectively. Conclusions: MISSION Act implementation was associated with substantial shifts in treatment site and federal payor for Veteran hospitalizations. Post-implementation readmission risk was estimated to be higher for those with CC and CMS index admissions, while post-implementation risk of ED utilization following CC admissions was estimated to be lower compared with VHA index admissions. Reasons for this divergence require further investigation. KEYWORDS care coordination, Department of Veterans Affairs, hospitalizations, VA MISSION Act, Veterans health What is known on this topic * Recent federal legislation increased Veterans' access to care in community hospital settings, including the VA Choice Act of 2014 and the MISSION Act of 2018. * Since MISSION Act implementation, little is known about post-hospitalization outcomes for care received in the community versus care received at the Veterans Health Administration (VHA) facilities. What this study adds * Veterans with VA-funded community care were estimated to have higher risk of readmission, but lower risk of post-discharge ED utilization compared with those with VA admissions. * MISSION Act implementation was associated with substantial shifts for Veteran hospitalizations toward VA-funded community care and away from VHA facilities and Medicare-funded admissions., 1 | INTRODUCTION The Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 contained measures to expand Veterans' access to timely care, including increased outsourcing of services [...]

PAISIELLO: La Finta Amante Elena Tsetkova (Camilletta), Daniele De Prosperi (Gelino), Antoine Bernheim (Don Girone); Estrin Orchestra/ Stefano Parisse Naxos 660563 [2CD] 114 minutes Opera lovers have heard about Giovanni [...]

AULETTA: L'Orazio Shira Patchornik (Leandro, Orazio), Valeria La Grotta (Giacomina, Ginevra), Matteo Loi (Lamberto), Martina Licari (Elisa), Natalia Kawalek (Lauretta), Camilo Delgado Diaz (Colagianni); Modo Antiquo/ Federico Maria Sardelli Dynamic [...]

Reducing greenhouse gas emissions and combating the climate crisis is requiring communities around the world to rethink how they generate their electricity. Of course, this is the great energy transition, [...]

CIMAROSA: L'Olimpiade Les Talens Lyriques/ Christophe Rousset Versailles 143 [2CD] 146 minutes DUVAL: Les Genies (les Caracteres de l'Amour) Royal Opera; Ensemble il Caravaggio/ Camille Delaforge Versailles 121 [2CD] 142 [...]

In a pleasing case of nominative determinism, British Airways' Flying with Confidence director, Captain Steve Allright, once reassured me: 'Remember that turbulence is uncomfortable but rarely dangerous. It is a [...]

When I served as a camp director for a mid-sized summer camp in east-central Nebraska, weather ranked among my greatest concerns for camper and staff safety. In the middle of [...]

As fresh oversight and assurance demands have been piled upon boards, much of the new workload has ended up on the audit committee's agenda. How are committees handling new duties such as cybersecurity, risk, compliance, finance talent, and technology? How is audit evolving to adapt?, As the regulatory environment grows in complexity and companies address new and continuing challenges, new expectations are placed on audit committees. The scope of their responsibilities continues to expand beyond [...]

Dellaira: The Leopard Kim Josephson (Don Fabrizio), Robynne Redmon (Princess Stella), Minghao Liu (Tancredi Falconeri), Margarita Parsamyan (Concetta), Yaqi Yang (Angelica), Frank Ragsdale (Father Pirrone), Kevin Short (Cavaliere Chevalley), Thandolwethu [...]

I had given a guest lecture on quantum physics at the University of Sao Paulo, when postgraduate students surrounded me and eagerly suggested I should have speculated more thoroughly on [...]

Many tax professionals have faced a residency issue with respect to state taxation. The U.S. Citizenship and Immigration Service (USCIS) grants approximately 1 million Green Cards and employee visas annually; [...]

It's 2018. At the International Air Transport Association's (IATA) annual conference in Sydney, Qatar Airways' former CEO Akbar al Baker declares that only a man could lead his airline, 'because [...]

MEYERBEER: Le Prophete Mane Galoyan (Berthe), Elizabeth DeShong (Fides), John Osborn (John of Leyden), Valerio Contaldo (Jonas), Edwin Crossley-Mercer (Oberthal), Guilhem Worms (Mathisen), James Platt (Zacharie); Lyon Opera Chorus, London [...]

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BUSONI: Doktor Faust Dietrich Henschel (Faust), Daniel Brenna (Mephistopheles), Wilhelm Schwinghammer (Wagner & Master of Ceremonies), Joseph Dahdah (Duke of Parma & A Soldier), Olga Bezsmertna (Duchess of Parma); Florence [...]

HANDEL: Jephtha David Portillo (Jephtha), Lauren Snouffer (Iphis), Clara Osowski (Storge), Aryeh Nussbaum Cohen (Hamor), Neal Davies (Zebul), Katelyn Lee (Angel); Music of the Baroque/ Jane Glover Reference 755 [2CD] […]

In 2022, as supply chains adjusted to the COVID-19 pandemic aftershocks, even historically stable industries continued to experience significant turmoil. For example, the printing-paper supply chain experienced disarray to the [...]

STANFORD: Shamus O'Brien Gemma Ni Bhriain (Nora, singing), Anna Brady (Nora speaking), Ami Hewitt (Kitty), Joseph Doody (Captain Trevor), Andrew Gavin (Mike Murphy), Brendan Collins (Shamus O'Brien), Rory Dunne (Father [...]