Processing and validation of inpatient Medicare Advantage data for use in hospital outcome measures.

Objective: To determine the feasibility of integrating Medicare Advantage (MA) admissions into the Centers for Medicare & Medicaid Services (CMS) hospital outcome measures through combining Medicare Advantage Organization (MAO) encounter- and hospital-submitted inpatient claims.

Data Sources And Study Setting: Beneficiary enrollment data and inpatient claims from the Integrated Data Repository for 2018 Medicare discharges.

Study Design: We examined timeliness of MA claims, compared diagnosis and procedure codes for admissions with claims submitted both by the hospital and the MAO (overlapping claims), and compared demographic characteristics and principal diagnosis codes for admissions with overlapping claims versus admissions with a single claim.

Incorporating Medicare Advantage Admissions Into the CMS Hospital-Wide Readmission Measure.

Importance: Medicare Advantage (MA) enrollment is rapidly expanding, yet Centers for Medicare & Medicaid Services (CMS) claims-based hospital outcome measures, including readmission rates, have historically included only fee-for-service (FFS) beneficiaries.

Objective: To assess the outcomes of incorporating MA data into the CMS claims-based FFS Hospital-Wide All-Cause Unplanned Readmission (HWR) measure.

Design, Setting, And Participants: This cohort study assessed differences in 30-day unadjusted readmission rates and demographic and risk adjustment variables for MA vs FFS admissions.

"Creating communities that care:" reflections from community leaders on Livability Academy, a neighborhood quality-of-life training program in Philadelphia.

"What does livability mean to us? Creating communities that care." This reflective praxis think-piece was a collective effort by graduates of the Livability Academy program, a community leadership program hosted in eastern North Philadelphia. Program participants worked in teams to implement programs to improve neighborhood quality of life, as those involved in implementing Livability Academy collaborated to strengthen the bottom-up, asset-based, network-driven model.

Physician practice check-up. Assessing a practice's readiness for electronic health records.

Federal incentives will take some of the pain out of transitioning a practice to an electronic health record system, but the transformation will be monumental, nonetheless. For practices that take the leap, focusing initial efforts on a readiness assessment lays a solid foundation for later success.