ArticleMedical care2016
Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations: Rationale, Methods, and Early Results.
Article in Medical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed.
- Association Between Initiation of Cardiac Rehabilitation after Hospitalization for Heart Failure and 1-Year Survival Among Medicare Beneficiaries.Journal of general internal medicine · 2026Article
- Comparing methods for assessing the reliability of health care quality measures.Statistics in medicine · 2024Article
- Split-sample reliability estimation in health care quality measurement: Once is not enough.Health services research · 2024Article
- Variation in Risk-Standardized Acute Admission Rates Among Patients With Heart Failure in Accountable Care Organizations: Implications for Quality Measurement.Journal of the American Heart Association · 2023Article
- Accountable Care Organizations and Health Disparities of Rural Latinos: A Longitudinal Analysis.Population health management · 2022Article
- Quality Measures in Heart Failure: the Past, the Present, and the Future.Current heart failure reports · 2019Review
- Comorbidity Type and Health Care Costs in Type 2 Diabetes: A Retrospective Claims Database Analysis.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2018Article
- Opportunities and Accountable Care Organizations.Journal of medical systems · 2016Article
- Analysis of Healthcare Cost and Utilization in the First Two Years of the Medicare Shared Savings Program Using Big Data from the CMS Enclave.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2016Article
- The Effects of Medicare Accountable Organizations on Inpatient Mortality Rates.Inquiry : a journal of medical care organization, provision and financingArticle
- ACOs' Impact on Hospitalization Rates of Rural Older Adults With Diabetes: Early Indications.Family & community healthArticle
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Authors and funding
13 authors.
Funding
Abstract
backgroundPopulation-based measures of admissions among patients with chronic conditions are important quality indicators of Accountable Care Organizations (ACOs), yet there are challenges in developing measures that enable fair comparisons among providers.
methodsOn the basis of consensus standards for outcome measure development and with expert and stakeholder input on methods decisions, we developed and tested 2 models of risk-standardized acute admission rates (RSAARs) for patients with diabetes and heart failure using 2010-2012 Medicare claims data. Model performance was assessed with deviance R; score reliability was tested with intraclass correlation coefficient. We estimated RSAARs for 114 Shared Savings Program ACOs in 2012 and we assigned ACOs to 3 performance categories: no different, worse than, and better than the national rate.
resultsThe diabetes and heart failure cohorts included 6.5 and 2.6 million Medicare Fee-For-Service beneficiaries aged 65 years and above, respectively. Risk-adjustment variables were age, comorbidities, and condition-specific severity variables, but not socioeconomic status or other contextual factors. We selected hierarchical negative binomial models with the outcome of acute, unplanned hospital admissions per 100 person-years. For the diabetes and heart failure measures, respectively, the models accounted for 22% and 12% of the deviance in outcomes and score reliability was 0.89 and 0.81. For the diabetes measure, 51 (44.7%) ACOs were no different, 45 (39.5%) were better, and 18 (15.8%) were worse than the national rate. The distribution of performance for the heart failure measure was 61 (53.5%), 37 (32.5%), and 16 (14.0%), respectively.
conclusionMeasures of RSAARs for patients with diabetes and heart failure meet criteria for scientific soundness and reveal important variation in quality across ACOs.
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