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Invited Commentary
December 2014

It Is More Than Payment Accountability: It Is About Improvement, Too

Author Affiliations
  • 1Louisiana State University Health Science Center, New Orleans
JAMA Surg. 2014;149(12):1278. doi:10.1001/jamasurg.2014.994

Using a large data set, Lucas et al1 studied the importance of appropriate risk adjustment when applying performance measures in payment and accountability programs. Despite limited variation in readmissions for colorectal cancer, a readmission rate of 12.3% should encourage all of us to strive to get below 10%. It is about improvement and accountability in payment and public reporting. The hierarchical logistic regression model used found variations in age, race, procedure, and comorbidities. Risk-adjusted readmission odds ratios revealed risks shared by all hospitals in these specific groups of variables. They also point to areas in need of focused improvements.

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