119 results on '"Bernheim, Susannah M."'
Search Results
102. EFFECTS OF REGIONAL MEDICARE ADVANTAGE PENETRATION ON RISK-STANDARDIZED OUTCOME MEASURES
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Kulkarni, Vivek T., primary, Shah, Sachin J., additional, Bernheim, Susannah M., additional, Wang, Yongfei, additional, Normand, Sharon-Lise T., additional, Drye, Elizabeth E., additional, and Krumholz, Harlan M., additional
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- 2011
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103. Expanding the Frontier of Outcomes Measurement for Public Reporting
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Ross, Joseph S., primary, Bernheim, Susannah M., additional, and Drye, Elizabeth D., additional
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- 2011
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104. National Patterns of Risk-Standardized Mortality and Readmission for Acute Myocardial Infarction and Heart Failure
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Bernheim, Susannah M., primary, Grady, Jacqueline N., additional, Lin, Zhenqiu, additional, Wang, Yun, additional, Wang, Yongfei, additional, Savage, Shantal V., additional, Bhat, Kanchana R., additional, Ross, Joseph S., additional, Desai, Mayur M., additional, Merrill, Angela R., additional, Han, Lein F., additional, Rapp, Michael T., additional, Drye, Elizabeth E., additional, Normand, Sharon-Lise T., additional, and Krumholz, Harlan M., additional
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- 2010
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105. An Administrative Claims Measure Suitable for Profiling Hospital Performance on the Basis of 30-Day All-Cause Readmission Rates Among Patients With Heart Failure
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Keenan, Patricia S., primary, Normand, Sharon-Lise T., additional, Lin, Zhenqiu, additional, Drye, Elizabeth E., additional, Bhat, Kanchana R., additional, Ross, Joseph S., additional, Schuur, Jeremiah D., additional, Stauffer, Brett D., additional, Bernheim, Susannah M., additional, Epstein, Andrew J., additional, Wang, Yongfei, additional, Herrin, Jeph, additional, Chen, Jersey, additional, Federer, Jessica J., additional, Mattera, Jennifer A., additional, Wang, Yun, additional, and Krumholz, Harlan M., additional
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- 2008
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106. Discerning quality: an analysis of informed consent documents for common cardiovascular procedures.
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Shahu, Andi, Schwartz, Jennifer, Perez, Mallory, Bernheim, Susannah M., Krumholz, Harlan M., and Spatz, Erica S.
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CARDIOVASCULAR surgery ,DOCUMENTATION ,INFORMED consent (Medical law) ,MEDICAL quality control ,READABILITY (Literary style) ,RESEARCH funding ,DECISION making in clinical medicine ,PATIENT-centered care ,PATIENT autonomy - Published
- 2017
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107. Socioeconomic Status And Readmission Rates.
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Grover, Atul, Bernheim, Susannah M., Krumholz, Harlan M., and Zhenqiu Lin
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CLINICAL medicine , *HEALTH facility administration , *MEDICAL quality control , *SOCIOECONOMIC factors , *KEY performance indicators (Management) , *PATIENT readmissions - Abstract
A letter to the editor is presented in response to the article "Accounting For Patients' Socioeconomic Status Does Not Change Hospital Readmission Rates," by Susannah Bernheim in the August 2016 issue.
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- 2016
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108. Post-discharge acute care and outcomes following readmission reduction initiatives: national retrospective cohort study of Medicare beneficiaries in the United States
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Khera, Rohan, Wang, Yongfei, Bernheim, Susannah M, Lin, Zhenqiu, and Krumholz, Harlan M
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ObjectivesTo determine whether patients discharged after hospital admissions for conditions covered by national readmission programs who received care in emergency departments or observation units but were not readmitted within 30 days had an increased risk of death and to evaluate temporal trends in post-discharge acute care utilization in inpatient units, emergency departments, and observation units for these patients.DesignRetrospective cohort study.SettingMedicare claims data for 2008-16 in the United States.ParticipantsPatients aged 65 or older admitted to hospital with heart failure, acute myocardial infarction, or pneumonia—conditions included in the US Hospital Readmissions Reduction Program.Main outcome measuresPost-discharge 30 day mortality according to patients’ 30 day acute care utilization; acute care utilization in inpatient and observation units and the emergency department during the 30 day and 31-90 day post-discharge period.Results3 772 924 hospital admissions for heart failure, 1 570 113 for acute myocardial infarction, and 3 131 162 for pneumonia occurred. The overall post-discharge 30 day mortality was 8.7% for heart failure, 7.3% for acute myocardial infarction, and 8.4% for pneumonia. Risk adjusted mortality increased annually by 0.05% (95% confidence interval 0.02% to 0.08%) for heart failure, decreased by 0.06% (−0.09% to −0.04%) for acute myocardial infarction, and did not significantly change for pneumonia. Specifically, mortality increased for patients with heart failure who did not utilize any post-discharge acute care, increasing at a rate of 0.08% (0.05% to 0.12%) per year, exceeding the overall absolute annual increase in post-discharge mortality in heart failure, without an increase in mortality in observation units or the emergency department. Concurrent with a reduction in 30 day readmission rates, stays for observation and visits to the emergency department increased across all three conditions during and beyond the 30 day post-discharge period. Overall 30 day post-acute care utilization did not change significantly.ConclusionsThe only condition with increasing mortality through the study period was heart failure; the increase preceded the policy and was not present among patients who received emergency department or observation unit care without admission to hospital. During this period, the overall acute care utilization in the 30 days after discharge significantly decreased for heart failure and pneumonia, but not for acute myocardial infarction.
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- 2020
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109. Measuring Equity in Readmission as a Distinct Assessment of Hospital Performance.
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Nash, Katherine A., Weerahandi, Himali, Yu, Huihui, Venkatesh, Arjun K., Holaday, Louisa W., Herrin, Jeph, Lin, Zhenqiu, Horwitz, Leora I., Ross, Joseph S., and Bernheim, Susannah M.
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MEDICAL quality control , *PATIENT readmissions , *HOSPITAL costs , *MEDICAID , *INSURANCE rates , *BLACK people - Abstract
Key Points: Question: Do hospitals achieve equitable readmission rates (ie, fewer readmissions with narrow gaps in readmission rates between populations)? What characterizes hospitals with equitable readmissions? Findings: Of eligible hospitals, 17% had equitable readmissions by insurance, and 30% had equitable readmissions by race. Hospitals with and without equitable readmissions were characteristically different. Achieving equitable readmissions did not consistently correlate with quality, cost, or value. Many hospitals were not eligible for a disparities assessment due to insufficient numbers of dual-eligible and Black patients. Meaning: A minority of hospitals achieve equitable readmissions. Equity-focused outcome measures assess new dimensions of hospital performance distinct from traditional accountability measures. Importance: Equity is an essential domain of health care quality. The Centers for Medicare & Medicaid Services (CMS) developed 2 Disparity Methods that together assess equity in clinical outcomes. Objectives: To define a measure of equitable readmissions; identify hospitals with equitable readmissions by insurance (dual eligible vs non–dual eligible) or patient race (Black vs White); and compare hospitals with and without equitable readmissions by hospital characteristics and performance on accountability measures (quality, cost, and value). Design, Setting, and Participants: Cross-sectional study of US hospitals eligible for the CMS Hospital-Wide Readmission measure using Medicare data from July 2018 through June 2019. Main Outcomes and Measures: We created a definition of equitable readmissions using CMS Disparity Methods, which evaluate hospitals on 2 methods: outcomes for populations at risk for disparities (across-hospital method); and disparities in care within hospitals' patient populations (within-a-single-hospital method). Exposures: Hospital patient demographics; hospital characteristics; and 3 measures of hospital performance—quality, cost, and value (quality relative to cost). Results: Of 4638 hospitals, 74% served a sufficient number of dual-eligible patients, and 42% served a sufficient number of Black patients to apply CMS Disparity Methods by insurance and race. Of eligible hospitals, 17% had equitable readmission rates by insurance and 30% by race. Hospitals with equitable readmissions by insurance or race cared for a lower percentage of Black patients (insurance, 1.9% [IQR, 0.2%-8.8%] vs 3.3% [IQR, 0.7%-10.8%], P <.01; race, 7.6% [IQR, 3.2%-16.6%] vs 9.3% [IQR, 4.0%-19.0%], P =.01), and differed from nonequitable hospitals in multiple domains (teaching status, geography, size; P <.01). In examining equity by insurance, hospitals with low costs were more likely to have equitable readmissions (odds ratio, 1.57 [95% CI, 1.38-1.77), and there was no relationship between quality and value, and equity. In examining equity by race, hospitals with high overall quality were more likely to have equitable readmissions (odds ratio, 1.14 [95% CI, 1.03-1.26]), and there was no relationship between cost and value, and equity. Conclusion and Relevance: A minority of hospitals achieved equitable readmissions. Notably, hospitals with equitable readmissions were characteristically different from those without. For example, hospitals with equitable readmissions served fewer Black patients, reinforcing the role of structural racism in hospital-level inequities. Implementation of an equitable readmission measure must consider unequal distribution of at-risk patients among hospitals. This cross-sectional study of US hospitals compared hospital and patient characteristics to evaluate equitable rates of readmission by insurance (dual eligible [Medicare and Medicaid] vs non–dual eligible) and race (Black vs White). [ABSTRACT FROM AUTHOR]
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- 2024
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110. Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions.
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Dharmarajan, Kumar, Hsieh, Angela F, Lin, Zhenqiu, Bueno, Héctor, Ross, Joseph S, Horwitz, Leora I, Barreto-Filho, José Augusto, Kim, Nancy, Suter, Lisa G, Bernheim, Susannah M, Drye, Elizabeth E, and Krumholz, Harlan M
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HOSPITALS ,HEART failure ,MYOCARDIAL infarction ,PNEUMONIA ,PROBABILITY theory ,RESEARCH funding ,RETROSPECTIVE studies ,PATIENT readmissions ,DESCRIPTIVE statistics ,OLD age - Abstract
The article presents the study which examined the readmission performance and patterns of readmission of high performing hospitals with low 30 day readmission rates and lower performing hospitals with higher rates of readmission. The study was conducted to Medicare beneficiaries aged 65 and older in the U.S. The results showed that hospitals could best lessen readmissions with strategies that reduce readmission risk worldwide.
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- 2014
111. Abstract 19
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Reilly, Emily M, Kim, Nancy, Bernheim, Susannah M, Ott, Lesli S, Hsieh, Angela, Xu, Xiao, Spivack, Steven, Han, Lein F, and Krumholz, Harlan M
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Objective:One approach to reduce health care spending and improve coordination of care is to pay for an episode of care rather than individual services. Anchoring these episodes around an index hospitalization is sensible because hospitalizations are a leading contributor to rising healthcare costs and an index admission provides a clear time to begin the episode. Understanding which care settings are responsible for a greater proportion of expenditures can inform efforts to improve efficiencies in the care provided. Our objectives were to: 1) characterize total episode payments for two conditions and 2) examine the care settings accounting for the highest proportions of the 30-day episode of care payment.
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- 2014
112. Abstract 13
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Dharmarajan, Kumar, Hsieh, Angela F, Lin, Zhenqiu, Kim, Nancy, Ross, Joseph S, Horwitz, Leora I, Kulkarni, Vivek, Suter, Lisa G, Bernheim, Susannah M, Drye, Elizabeth E, Normand, Sharon-Lise, and Krumholz, Harlan M
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Background:After hospitalization for heart failure (HF) and acute myocardial infarction (AMI), patients experience increased risk of death and hospital readmission. Defining the trajectory and timing of this period of risk may help guide interventions to improve post-discharge outcomes.
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- 2013
113. Abstract 20
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Spivack, Steven B, Ott, Lesli S, Kim, Nancy, Xu, Xiao, Han, Lein, Krumholz, Harlan M, Liu, Alex, Volpe, Mark, and Bernheim, Susannah M
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Objective:We examined how payments for a 30-day episode-of-care following AMI differ for hospitals with higher and lower proportions of dual-eligible AMI patients.
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- 2013
114. Abstract P41
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Bernheim, Susannah M, Bhat, Kanchana, Savage, Shantal, Phipps, Michael, Drye, Elizabeth, Ross, Joseph S, Desai, Mayur, Krumholz, Harlan, and Lichtman, Judith H
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- 2011
115. Abstract P27
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Lichtman, Judith H, Leifheit-Limson, Erica C, Jones, Sara B, Watanabe, Emi, Bhat, Kanchana, Savage, Shantal V, Phipps, Michael, Bernheim, Susannah M, and Krumholz, Harlan M
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- 2011
116. Abstract P41
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Bernheim, Susannah M, Bhat, Kanchana, Savage, Shantal, Phipps, Michael, Drye, Elizabeth, Ross, Joseph S, Desai, Mayur, Krumholz, Harlan, and Lichtman, Judith H
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Objectives:Risk-standardized mortality is increasingly recognized as an important measure of hospital quality. We conducted a systematic review to identify models of morality after stroke developed to profile hospitals or predict patient mortality within 1 year of stroke hospitalization.
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- 2010
117. Abstract P27
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Lichtman, Judith H, Leifheit-Limson, Erica C, Jones, Sara B, Watanabe, Emi, Bhat, Kanchana, Savage, Shantal V, Phipps, Michael, Bernheim, Susannah M, and Krumholz, Harlan M
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Objective:Hospital readmission has been used to risk-stratify patients and profile hospitals by public reporting of performance measures. We conducted a systematic review to identify models developed to compare hospital rates of readmission or predict patients' risk of readmission after stroke, and identify characteristics independently associated with readmission in these models.
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- 2010
118. Age Differences in Hospital Mortality for Acute Myocardial Infarction: Implications for Hospital Profiling.
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Dharmarajan, Kumar, McNamara, Robert L., Yongfei Wang, Masoudi, Frederick A., Ross, Joseph S., Spatz, Erica E., Desai, Nihar R., de Lemos, James A., Fonarow, Gregg C., Heidenreich, Paul A., Bhatt, Deepak L., Bernheim, Susannah M., Slattery, Lara E., Khan, Yosef M., Curtis, Jeptha P., and Wang, Yongfei
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HOSPITAL statistics , *AGE distribution , *HOSPITALS , *HEALTH outcome assessment , *RETROSPECTIVE studies , *HOSPITAL mortality ,MYOCARDIAL infarction-related mortality - Abstract
Background: Publicly reported hospital risk-standardized mortality rates (RSMRs) for acute myocardial infarction (AMI) are calculated for Medicare beneficiaries. Outcomes for older patients with AMI may not reflect general outcomes.Objective: To examine the relationship between hospital 30-day RSMRs for older patients (aged ≥65 years) and those for younger patients (aged 18 to 64 years) and all patients (aged ≥18 years) with AMI.Design: Retrospective cohort study.Setting: 986 hospitals in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines.Participants: Adults hospitalized for AMI from 1 October 2010 to 30 September 2014.Measurements: Hospital 30-day RSMRs were calculated for older, younger, and all patients using an electronic health record measure of AMI mortality endorsed by the National Quality Forum. Hospitals were ranked by their 30-day RSMRs for these 3 age groups, and agreement in rankings was plotted. The correlation in hospital AMI achievement scores for each age group was also calculated using the Hospital Value-Based Purchasing (HVBP) Program method computed with the electronic health record measure.Results: 267 763 and 276 031 AMI hospitalizations among older and younger patients, respectively, were identified. Median hospital 30-day RSMRs were 9.4%, 3.0%, and 6.2% for older, younger, and all patients, respectively. Most top- and bottom-performing hospitals for older patients were neither top nor bottom performers for younger patients. In contrast, most top and bottom performers for older patients were also top and bottom performers for all patients. Similarly, HVBP achievement scores for older patients correlated weakly with those for younger patients (R = 0.30) and strongly with those for all patients (R = 0.92).Limitation: Minority of U.S. hospitals.Conclusion: Hospital mortality rankings for older patients with AMI inconsistently reflect rankings for younger patients. Incorporation of younger patients into assessment of hospital outcomes would permit further examination of the presence and effect of age-related quality differences.Primary Funding Source: American College of Cardiology. [ABSTRACT FROM AUTHOR]- Published
- 2017
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119. The 2018 Merit-based Incentive Payment System: Participation, Performance, and Payment Across Specialties.
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Gettel CJ, Han CR, Canavan ME, Bernheim SM, Drye EE, Duseja R, and Venkatesh AK
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- Cross-Sectional Studies, Humans, Motivation, Quality of Health Care, United States, Medicare statistics & numerical data, Quality Indicators, Health Care statistics & numerical data, Reimbursement, Incentive statistics & numerical data
- Abstract
Background: The Merit-based Incentive Payment System (MIPS) incorporates financial incentives and penalties intended to drive clinicians towards value-based purchasing, including alternative payment models (APMs). Newly available Medicare-approved qualified clinical data registries (QCDRs) offer specialty-specific quality measures for clinician reporting, yet their impact on clinician performance and payment adjustments remains unknown., Objectives: We sought to characterize clinician participation, performance, and payment adjustments in the MIPS program across specialties, with a focus on clinician use of QCDRs., Research Design: We performed a cross-sectional analysis of the 2018 MIPS program., Results: During the 2018 performance year, 558,296 clinicians participated in the MIPS program across the 35 specialties assessed. Clinicians reporting as individuals had lower overall MIPS performance scores (median [interquartile range (IQR)], 80.0 [39.4-98.4] points) than those reporting as groups (median [IQR], 96.3 [76.9-100.0] points), who in turn had lower adjustments than clinicians reporting within MIPS APMs (median [IQR], 100.0 [100.0-100.0] points) (P<0.001). Clinicians reporting as individuals had lower payment adjustments (median [IQR], +0.7% [0.1%-1.6%]) than those reporting as groups (median [IQR], +1.5% [0.6%-1.7%]), who in turn had lower adjustments than clinicians reporting within MIPS APMs (median [IQR], +1.7% [1.7%-1.7%]) (P<0.001). Within a subpopulation of 202,685 clinicians across 12 specialties commonly using QCDRs, clinicians had overall MIPS performance scores and payment adjustments that were significantly greater if reporting at least 1 QCDR measure compared with those not reporting any QCDR measures., Conclusions: Collectively, these findings highlight that performance score and payment adjustments varied by reporting affiliation and QCDR use in the 2018 MIPS., Competing Interests: A.K.V. serves on the Clinical Emergency Data Registry (CEDR) Committee and within several other quality measurement related roles in the American College of Emergency Physicians. A.K.V. is also supported by the Moore Foundation, the American College of Emergency Physicians, the American College of Radiology, and the Foundation for Opioid Response Efforts for work developing quality measures or programs such as the Emergency Quality Network intended to be used for CMS MIPS Program participation. A.K.V., S.M.B., and E.E.D. also receive support for contracted work from the Centers for Medicare and Medicaid Services to develop hospital and health care outcome and efficiency quality measures and rating systems. The remaining authors declare no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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