Development of claims-based measures of unplanned acute care with superior power for assessing the effectiveness of interventions following acute care.

Objective: To develop outcome measures that are more sensitive than current measures for evaluating primary or transitional care after hospitalizations, emergency department (ED) visits, or observation stays.

Data Sources: Medicare claims data from January 1, 2015, to October 31, 2017, for 1 261 707 Medicare fee-for-service beneficiaries served by (a) primary care practices participating in Track 1 of the Comprehensive Primary Care Plus (CPC+) initiative, and (b) their matched comparison practices.

Study Design: Given the poor statistical power in many studies to detect effects on readmissions, we developed two novel claims-based measures of unplanned acute care (UAC) following an index acute care event.

Estimating the hospital costs of inpatient harms.

Objective: To estimate the additional hospital costs associated with inpatient medical harms occurring during an index inpatient admission and costs from subsequent readmissions within 90 days.

Data Source: 2009 to 2011 Healthcare Cost and Utilization Project's State Inpatient Databases from 12 states.

Study Design: We compare hospital costs incurred by patients experiencing a specific harm during their hospital stay to the costs incurred by similar patients who did not experience that harm.

Costs to Medicare of the Informatics for Diabetes Education and Telemedicine (IDEATel) home telemedicine demonstration: findings from an independent evaluation.

Objective: To estimate the impacts on Medicare costs of providing a particular type of home telemedicine to eligible Medicare beneficiaries with type 2 diabetes.

Research Design And Methods: Two cohorts of beneficiaries (n = 1,665 and 504, respectively) living in two medically underserved areas of New York between 2000 and 2007 were randomized to intensive nurse case management via televisits or usual care. Medicare service use and costs covering a 6-year follow-up period were drawn from claims data.