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161. Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmissions Webinar 1 (ppt file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar1/aspire_webinar1.ppt
     January 01, 2011 - Patients with readmission risks are not limited to Medicare Limited, Diagnosis-Specific Focus Heart … failure, heart attack, pneumonia, COPD, hip/knee replacement These are not the most frequent diagnoses … 44 (19.2%) and 45-64 (21.6%) are higher than Medicare all-cause readmission rates (17.3%) Medicaid heart … failure readmission rates are higher than Medicare rates: 29.1% versus 23.7% Strategies developed

162. Continuity of Coverage: Duration of First Observed Enrollment: Appendix Table 1 (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-156-table1.pdf
     June 02, 2025 - Continuity of Coverage: Duration of First Observed Enrollment: Appendix Table 1 Appendix Table 1. ICD-9-CM codes of the chronic conditions included in this analysis Category Specific Codes Diabetes, 250-250.91 Metabolic Disorders, 270-273.9; 275-.9 270 Disorders of amino-acid transport and metabolism 271 D…

163. Chartbook on Hispanic Health Care: Slide Presentation | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/nhqrdr/2014chartbooks/hispanichealth/hisph-slides.html
     March 01, 2020 - Hispanics and Whites had similar rates of admission for congestive heart failure. … Slide 35 Adult admissions for congestive heart failure per 100,000 population, by race/ethnicity, … 2002-2012 Image: Graph shows adult admissions for congestive heart failure per 100,000 population: … Importance: Racial disparities in care for congestive heart failure have been observed. … Trends: From 2002 to 2012, the rate of admission for congestive heart failure among adults decreased

164. The CAHPS Ambulatory Care Improvement Guide: Open Notes (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/access/cahps-strategy-6c.pdf
     March 01, 2017 - For example, a patient whose chart includes an unfamiliar reference to “congestive heart failure” might

165. Seamless Care: Safe Patient Transitions from Hospital to Home (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Spehar.pdf
     April 18, 2004 - Average direct costs were lower at the VA hospital for CABG patients, but were higher for heart failure … Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. … Applying the transitional care model to elderly patients with heart failure. … Comprehensive discharge planning with postdischarge support for older patients with congestive heart … A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart

166. Peterson, Pamela | Agency for Healthcare Research and Quality
     www.ahrq.gov/funding/training-grants/grants/active/kawards/Kawdsumpete.html
     October 01, 2014 - Peterson's long-term career goal is to improve outcomes for patients with heart failure through comparative

167. Introduction and Purpose | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/ptmgmt/introduction.html
     July 01, 2018 - Patients with chronic illnesses such as asthma, cardiovascular disease, depression, diabetes, heart failure

168. Arm in Arm with AcademyHealth, AHRQ is Poised to Build on Successes in Health Services Research | Agency for Healthcare Research and Quality
     www.ahrq.gov/news/blog/ahrqviews/arm-in-arm-with-academyhealth.html
     June 01, 2024 - adverse event diminished for five patient groups: 41 percent for heart attack patients, 27 percent for heart … failure patients, 36 percent for pneumonia patients, 41 percent for major surgery patients, and 18 percent

169. Getting Started Laying the Groundwork Coordination for Implementing Automatic Referral & Effective Care
     www.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/getting-started-slides.pptx
     December 31, 2022 - valve replacement or repair, or a heart or heart-lung transplant Chronic stable angina Chronic stable heart … failure 14 This slide reviews evidence about the benefits of CR and can be used to MAKE THE CASE to … 27 A coronary angioplasty or coronary stent 24 A heart or heart-lung transplant 4 Stable chronic heart … failure 3 Our CR Program's External Referrals and Enrollments: 2021 External Referrals Jan Feb Mar … failure 19 23 13 27 24 4 3 Leading Reasons for Physician Opt-Outs of Eligible Patients Q1 Extreme

170. Table 5. Other EHR-based Care Coordination Measures | Agency for Healthcare Research and Quality
     www.ahrq.gov/ncepcr/care/coordination/atlas/chapter4tab5.html
     June 01, 2014 - respond to change, Health IT-enabled coordination eMeasure specifications available: No Heart … Failure Follow-Up Visit Scheduled k Percent of patients, regardless of age, discharged to ambulatory … care or home health care with a principal discharge diagnosis of heart failure for whom a followup appointment

171. TeamSTEPPS Research/Evidence Base: TeamSTEPPS and Patients and Families | Agency for Healthcare Research and Quality
     www.ahrq.gov/teamstepps-program/evidence-base/patients-families.html
     June 01, 2023 - Engaging patients and families to transform heart failure care.

172. Outcome Indicators for the HCBS Population | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/find4.html
     December 01, 2012 - Congestive Heart Failure.

173. Getting Started  | Agency for Healthcare Research and Quality
     www.ahrq.gov/takeheart/training/getting-started/index.html
     April 01, 2023 - Bryant , BSN RN, Cardiac Rehab/Heart Failure Nurse Manager, Prairie Heart Institute at HSHS St.

174. Section 3: Selecting and Targeting Populations for a Care Management Program | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm3.html
     October 01, 2014 - to include members diagnosed with specific chronic diseases, the most common being asthma, diabetes, congestive … heart failure (CHF), coronary artery disease (CAD), and chronic obstructive pulmonary disorder (COPD … Congestive heart failure.

175. Table 3b. Examples of Evaluation Measures; Additional Categories | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/ptmgmt/evaluation-table3b.html
     July 01, 2018 - table, common chronic conditions are defined as asthma, cardiovascular disease, depression, diabetes, heart … failure, and migraine headaches.

176. C1 Prioritization Worksheet (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c1_combo_prioritizationworksheet.pdf
     June 02, 2025 - Device Fragment Count PSI 16 Transfusion Reaction Conditions Composite IQI 15 AMI Mortality IQI 16 Heart … Failure Mortality IQI 17 Acute Stroke Mortality AHRQ Inpatient Mortality for Selected Conditions

177. Webinar 1: Introduction & Overview: Slide Presentation | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/hospital/resource/guide/web1.html
     December 01, 2017 - Limited, Diagnosis-Specific Focus: Heart failure, heart attack, pneumonia, COPD, hip/knee replacement … Medicaid heart failure readmission rates are higher than Medicare rates: 29.1% versus 23.7%.

178. Racial Disparities in Patient Safety Indicator (PSI) Rates in the Veterans Health Administration (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Shimada_65.pdf
     April 04, 2008 - The comorbidities include congestive heart failure, valvular disease, pulmonary circulation disorders … 0.51 Comorbidities (%) Deficiency anemias 11.46 10.67 14.56 10.87 12.16 12.01 Congestive … heart failure 7.22 7.36 6.98 5.49 7.04 6.32 Depression 5.63 6.06 4.18 4.49 5.34 6.81 Diabetes … Impact of race on health care utilization and outcomes in veterans with congestive heart failure.

179. PowerPoint Presentation
     www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/changing-system-slides.pptx
     June 01, 2021 - PowerPoint Presentation Changing the System To Improve Patient Safety Long-Term Care AHRQ Safety Program for Improving Antibiotic Use AHRQ Pub. No. 17(21)-0029 June 2021 Changing the System 1 Objectives Use barriers as opportunities to improve systems and prevent problems from recurring. List factors that may comp…

180. Unique Challenges in Approaching Diagnostic Safety in Older Adults | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-older-adults2.html
     September 01, 2024 - prognosis. 12 Similarly, increasing age has been found to be associated with poorer diagnostic accuracy of heart … failure, with older patients being less likely to receive echocardiograms. 5 , 13 Several studies have … Heart failure. Parkinson’s disease. Stroke/transient ischemic attack. Acute myocardial infarction. … Heart failure (15%). Depression (16%). … failure in older adults, thus leading to the prescription of a diuretic medication. 62 In addition,