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Essay

COVID Could Surge Anywhere. This Tool Helps Hospitals Prepare

Jul 1, 2020

The number of new coronavirus cases is growing in most states. As the pandemic continues to strain U.S. health care systems, a tool developed by RAND researchers can help hospitals prepare for the worst.
Report

Setting U.S. Hospital Prices Could Cut Overall Health Spending by Billions

Feb 18, 2021

Price regulations face political obstacles and have been strongly opposed by medical providers. But setting prices for all commercial health care payers could reduce hospital spending by $61.9 billion to $236.6 billion a year if the rates were set at 100 to 150 percent of the amounts paid by Medicare.

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Research Brief

Private U.S. Health Plans Pay Hospitals 247 Percent of What Medicare Would Pay

RAND researchers used data from 49 states and Washington, D.C., to assess hospital prices paid by private health plans. Data sources included $33.8 billion in spending from 3,112 community hospitals—more than half of community hospitals nationwide.

Feb 24, 2021
News Release

Setting Hospital Prices Can Achieve Greater Savings Than Increasing Competition or Price Transparency

Among strategies to curb hospital prices among the commercially insured population in the United States, direct price regulations such as setting rates are likely to achieve greater savings than other approaches like increasing competition or improving price transparency.

Feb 18, 2021
Journal Article

What Drives Greater Assimilation of Telestroke in Emergency Departments?

Although many emergency departments (EDs) have telestroke capacity, it is unclear why some EDs consistently use telestroke and others do not. We compared the characteristics and practices of EDs with robust and low assimilation of telestroke.

Feb 10, 2021
Journal Article

Medicare Shared Savings Program and Readmission Rate Among Patients with Ischemic Stroke

Our aim was to determine if the Medicare Shared Savings Program is associated with changes in readmissions and mortality for patients hospitalized with ischemic stroke, and whether it has a different impact on safety net hospitals and non-SNHs.

Jan 29, 2021
Journal Article

Improving The Accuracy Of Hospital Quality Ratings By Focusing On The Association Between Volume And Outcome

The goal of this exploratory analysis was to examine the changes in hospital star rankings for aortic valve replacement when shrinkage targets based on hospital case volume are used instead of the standard CMS approach.

Jan 28, 2021
Journal Article

Impact of Risk Adjustment for Socioeconomic Status on Risk-adjusted Surgical Readmission Rates

This article assesses whether differences in readmission rates between safety-net hospitals (SNH) and non-SNHs are due to differences in hospital quality, and compares the results of hospital profiling with and without adjusting for socioeconomic status.

Jan 28, 2021
Journal Article

Impact of Hospital Readmissions Reduction Program Penalties on Hip and Knee Replacement Readmissions: Comparison of Hospitals at Risk of Varying Penalty Amounts

We examined whether hospitals at risk of relatively large penalties from this expansion experienced greater declines in joint replacement readmissions compared with hospitals at risk of smaller penalties.

Jan 28, 2021
Journal Article

Penalties and Rewards for Safety Net Vs Non-Safety Net Hospitals in the First 2 Years of the Comprehensive Care for Joint Replacement Model

We assessed whether safety net hospitals, which serve vulnerable patients, were more likely to be penalized and less likely to receive rewards compared with non-safety net hospitals that serve few vulnerable patients.

Jan 22, 2021
Journal Article

Measuring Childbirth Outcomes Using Administrative and Birth Certificate Data

The aim of this study was to develop a risk-adjusted composite measure of severe maternal morbidity and severe newborn morbidity based on administrative and birth certificate data.

Jan 22, 2021
Journal Article

Performance Of Safety-Net Hospitals In Year 1 Of The Comprehensive Care For Joint Replacement Model

This article finds safety-net hospitals were less likely to receive rewards in year one of the Comprehensive Care for Joint Replacement model because of their quality and spending performance.

Jan 21, 2021
Journal Article

Variation in Readmission Rates Among Hospitals Following Admission for Traumatic Injury

We wished to determine if hospitals differed in their adjusted readmission rates following an index hospital admission for traumatic injury.

Jan 20, 2021
Journal Article

Does Medicare Advantage Reduce Racial Disparity in 30-Day Rehospitalization for Medicare Beneficiaries?

This study determined potential racial and ethnic disparities in risk for all-cause 30-day readmission among traditional Medicare and Medicare Advantage beneficiaries initially hospitalized for acute myocardial infarction, congestive heart failure, or pneumonia.

Jan 14, 2021
Journal Article

Impact on Hospital Ranking of Basing Readmission Measures on a Composite Endpoint of Death or Readmission Versus Readmissions Alone

Hospital performance on readmissions is significantly different from hospital performance on a composite metric based on readmission and mortality.

Jan 14, 2021
Journal Article

Quality of Quality Measurement: Impact of Risk Adjustment, Hospital Volume, and Hospital Performance

Monte Carlo simulation was used to examine the accuracy of performance profiling as a function of statistical methodology, case volume, and the extent to which hospital or physician performance deviates from the average.

Dec 31, 2020
Journal Article

Impact of Medicare's Nonpayment Program on Hospital-acquired Conditions

This article determines whether Medicare's Nonpayment Program was associated with changes in incidence of hospital-acquired conditions, and whether this association varies across hospitals with differential Medicare patient load.

Dec 31, 2020
Journal Article

Hospital Readmission After Noncardiac Surgery: The Role of Major Complications

To examine whether the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) predicted risk of major complications can be used to identify surgical patients at risk for rehospitalization.

Dec 22, 2020
Journal Article

Impact of Present-on-admission Indicators on Risk-adjusted Hospital Mortality Measurement

We sought to develop and validate a risk index for in-hospital mortality using only present-on-admission diagnoses, principal procedures, and secondary procedures occurring before the date of the principal procedure.

Dec 10, 2020
Commentary

How Hospitals Could Step in to Help Manage GP Practices

The supply of doctors in primary care, known as 'GPs' in the UK, is falling behind a growing demand for their services, as GPs leave general practice in large numbers. One way to help struggling GP practices could be vertical integration—combining health care organizations operating at different stages along the patient pathway.

Dec 1, 2020
Journal Article

Barriers and Facilitators of Kangaroo Mother Care Adoption in Five Chinese Hospitals: A Qualitative Study

We provided a comprehensive report on the multi-level KMC barriers and facilitators in China. We recommend policy interventions addressing these barriers and facilitators and increase family and peer support to improve KMC adoption in China.

Nov 12, 2020

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