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Medicare Advantage and rural hospital profitability.
J Rural Health
January 2025
Department of Health Policy and Management, UNC Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, North Carolina, USA.
Purpose: This study compares 2018-2023 Medicare Advantage (MA) days as a percentage of total Medicare days in rural and urban hospitals, describes 2022-2023 operating profitability of rural and urban hospitals by quartiles of MA days as a percentage of total Medicare days, and explores hospital characteristics that may be important for understanding the relationship between MA and profitability of rural hospitals.
Methods: Financial and hospital data were obtained from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) for the years 2018 to 2023. Hospitals were assigned to quartiles based on MA days as a percentage of total Medicare days.
Depression is Associated with Treatment Response Trajectories in Adults with Prolonged Grief Disorder: A Machine Learning Analysis.
medRxiv
December 2024
Department of Psychiatry, New York University Grossman School of Medicine, New York, New York.
Unlabelled: Although evidence-based treatments for Prolonged Grief Disorder (PGD) exist, pretreatment characteristics associated with differential improvement trajectories have not been identified. To identify clinical factors relevant to optimizing PGD treatment outcomes, we used unsupervised and supervised machine learning to study treatment effects from a double-blinded, placebo-controlled, randomized clinical trial. Participants were randomized into four treatment groups for 20 weeks: citalopram with grief-informed clinical management, citalopram with prolonged grief disorder therapy (PGDT), pill placebo with PGDT, or pill placebo with clinical management.
View Article and Find Full Text PDFExternal Validation of the Neiman Imaging Comorbidity Index in Medicare, Medicaid, and Private Payer Claims Data.
J Am Coll Radiol
December 2024
Director of Economic and Health Services Research, The Harvey L. Neiman Health Policy Institute, Reston, Virginia.
Objective: The Neiman Imaging Comorbidity Index (NICI) was developed and validated in a claims dataset encompassing >10 million privately insured beneficiaries, in which it outperformed the commonly used Charlson Comorbidity Index (CCI) in predicting advanced imaging use. This external validation assessed the broader generalizability of NICI for predicting receipt of advanced imaging in nationally representative populations, including patients insured by Medicare, Medicaid, and private payers.
Methods: All 2018 to 2019 patient-level claims from the CMS Medicare 5% Research Identifiable File, CMS Medicaid 100% Research Identifiable File, and private insurance (commercial and Medicare Advantage) claims from Inovalon Insights, LLC, were included.
Large Language Models for More Efficient Reporting of Hospital Quality Measures.
NEJM AI
October 2024
Division of Biomedical Informatics, University of California, San Diego, San Diego.
Hospital quality measures are a vital component of a learning health system, yet they can be costly to report, statistically underpowered, and inconsistent due to poor interrater reliability. Large language models (LLMs) have recently demonstrated impressive performance on health care-related tasks and offer a promising way to provide accurate abstraction of complete charts at scale. To evaluate this approach, we deployed an LLM-based system that ingests Fast Healthcare Interoperability Resources data and outputs a completed Severe Sepsis and Septic Shock Management Bundle (SEP-1) abstraction.
View Article and Find Full Text PDFAn innovative model of behavioral healthcare for older adults with serious mental illness, substance use disorders, and dementia.
J Am Geriatr Soc
December 2024
Author Health; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Introduction: Older adults with serious mental illness (SMI) experience higher rates of medical comorbidities, mortality, hospital readmissions, and total healthcare spending when compared with Medicare beneficiaries without SMI. Although telehealth provides an opportunity to overcome barriers to behavioral healthcare access, older adults face unique challenges when accessing and utilizing telehealth services. We present Author Health's care model, which integrates virtual-first behavioral health care with an interdisciplinary approach to health-related social needs (HRSN) screening and intervention in older adults.
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