National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Blood Clots (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (4)
- Health Insurance (1)
- Hospital Discharge (1)
- Hospitalization (1)
- (-) Hospitals (6)
- Intensive Care Unit (ICU) (1)
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- Medicare (3)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedLau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Brown TT, Robinson JC
Reference pricing with endogenous or exogenous payment limits: impacts on insurer and consumer spending.
The authors extended reference pricing (RP) models to a hospital context focusing on insurer and consumer payments. They found that, for 2 years following RP implementation, insurer payments to high-price and low-price hospitals moved downward, consistent with endogenous RP. When the reference price was not reset to account for changes in market prices, insurer payments to low-price hospitals reverted to pre-implementation levels, consistent with exogenous RP.
AHRQ-funded; HS022098.
Citation: Brown TT, Robinson JC .
Reference pricing with endogenous or exogenous payment limits: impacts on insurer and consumer spending.
Health Econ 2016 Jun;25(6):740-9. doi: 10.1002/hec.3181.
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Keywords: Payment, Healthcare Costs, Health Insurance, Hospitals
Das A, Norton EC, Miller DC
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
In fiscal year 2015 the Centers for Medicare and Medicaid Services expanded its Hospital Value-Based Purchasing program by rewarding or penalizing hospitals for their performance on both spending and quality. Using data from 2,679 US hospitals that participated in the program in fiscal years 2014 and 2015, researchers found that the new emphasis on spending rewarded not only low-spending hospitals but some low-quality hospitals as well.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Adding a spending metric to Medicare's value-based purchasing program rewarded low-quality hospitals.
Health Aff 2016 May;35(5):898-906. doi: 10.1377/hlthaff.2015.1190.
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Keywords: Medicare, Provider Performance, Payment, Hospitals, Healthcare Costs, Quality of Care
Sommers BD, Stone J, Kane N
Predictors of payer mix and financial performance among safety net hospitals prior to the Affordable Care Act.
The objective of this study was to use audited hospital financial statements to identify predictors of payer mix and financial performance in safety net hospitals prior to the Affordable Care Act. It found that university governance was the strongest positive predictor of operating margin. Safety net hospital financial performance varied considerably. Academic hospitals had higher operating margins, while more generous Medicaid eligibility and reimbursement policies improved hospitals' ability to recoup costs.
AHRQ-funded; HS021291.
Citation: Sommers BD, Stone J, Kane N .
Predictors of payer mix and financial performance among safety net hospitals prior to the Affordable Care Act.
Int J Health Serv 2016;46(1):166-84. doi: 10.1177/0020731415586408.
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Keywords: Hospitals, Policy, Medicaid, Payment
Sjoding MW, Valley TS, Prescott HC
Rising billing for intermediate intensive care among hospitalized Medicare bbetween 1996 and 2010.
This study characterized trends in intermediate care use among U.S. hospitals. Only 8.2 percent of Medicare hospitalizations in 1996 were billed for intermediate care, but billing steadily increased to 22.8 percent by 2010, whereas the percentage billed for ICU care and ward-only care declined. Patients billed for intermediate care had more acute organ failures diagnoses codes compared with general ward patients.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Valley TS, Prescott HC .
Rising billing for intermediate intensive care among hospitalized Medicare bbetween 1996 and 2010.
Am J Respir Crit Care Med 2016 Jan 15;193(2):163-70. doi: 10.1164/rccm.201506-1252OC.
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Keywords: Payment, Hospitals, Intensive Care Unit (ICU), Healthcare Costs, Medicare
Das A, Norton EC, Miller DC
Association of postdischarge spending and performance on new episode-based spending measure.
The Centers for Medicare and Medicaid Services recently added the Medicare Spending per Beneficiary (MSPB) metric to its Hospital Value-Based Purchasing (HVBP) program. The researchers evaluated whether hospital performance was driven by spending before, during, or after hospitalization. They found that compared with low-cost hospitals, high-cost hospitals had significantly higher preadmission and index admission spending, but the largest differences were in postdischarge spending.
AHRQ-funded; HS020671.
Citation: Das A, Norton EC, Miller DC .
Association of postdischarge spending and performance on new episode-based spending measure.
JAMA Intern Med 2016 Jan;176(1):117-9. doi: 10.1001/jamainternmed.2015.6261.
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Keywords: Healthcare Costs, Medicare, Hospitals, Provider Performance, Hospitalization, Payment, Hospital Discharge