How does Johns Hopkins Medicine perform? Indicator set: National Healthcare Agreement (2020) The current average represents a slight decrease in all-cause readmission rates. Lastly, establishing effective multidisciplinary rounds that leverages the expertise of nursing, therapy, case management and pharmacy is a key component of TeamHealths ability to reduce a patients readmission risk. Through our more than 15,000 affiliated healthcare professionals and advanced practice clinicians, TeamHealth offers emergency medicine, hospital medicine, critical care, anesthesiology, orthopedic surgery, general surgery, obstetrics, ambulatory care, post-acute care and medical call center solutions to approximately 2,900 acute and post-acute facilities and physician groups nationwide. Smaller standalone hospitals will like consider partnerships, accelerating [mergers and acquisitions].. The average readmission cost was $15,200, ranging from $10,900 for self-pay/no charge stays to $16,400 for privately insured stays. Chico Hot Springs Restaurant Menu, Learn more at www.teamhealth.com. Top 3 Barriers of Healthcare Interoperability . News. The 2019 Chartbook was released on Thursday. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Hospital Readmissions Reduction Program (HRRP), Chronic obstructive pulmonary disease (COPD), Coronary artery bypass graft (CABG) surgery, Elective primary total hip arthroplasty and/or total knee arthroplasty (THA/TKA). According to recent data compiled by the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services, TeamHealths 30-day hospital readmission rate was only 6.8% significantly lower than the national benchmark range of 13.9%-20%. Overall rating Number of hospitals (N=4,586, %) 1 star : 198 (6.34%) 2 stars : . The organizations quality and safety performance may have been impacted by the COVID-19 pandemic. Payment reductions are applied to all Medicare fee-for-service base operating diagnosis-related group payments during the FY (October 1 to September 30). The national benchmark is based on data compiled by AHRQs Healthcare Cost and Utilization Project from 2010-2016 and CMS from 2018-2020. The Issue of Readmission Rates. In hospitals across the country, they make clinical quality and patient safety their top priority every day. 2021 American Association of Nurse Practitioners National Conference (AANP 2021); June 15-20 . or lock 2022 Dec;42(12):1025-1030. doi: 10.1007/s40261-022-01220-z. Hospitals by Procedure, 2010. Digital health technology in the prevention of heart failure and coronary artery disease. I work to understand the motivations of my patients, educate them and, where needed, offer a bundle of services for the highest-risk patients. Johns Hopkins Medicine attempts to fully prepare all patients before discharge and offers many programs for patients who need extra support after returning home. Readmission Rates Value of Care The following top hospitals have hospital wide unplanned readmission rates better than the national average rate. The Review and Correction period for HRRP is only for discrepancies related to the calculation of the payment reduction and component results. the National Committee for Quality Assurance, Center for Health Care Strategies, AcademyHealth, and Aurrera Health Group. Is the patient correctly taking their medications? Threats To External Validity Aba, Keywords care, compassion, empathy, empower, self-discharge, qualitative References Alfandre, D. J. In addition, CMS reports hospitals HRRP data onthe Provider Data Catalog. (CY) 2021 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS-1736-P). This pause in reporting was done to address issues with the Medicare claims submitted by Maryland hospitals. national hospital readmission rates 2021charge with a crime 6 letters. Three readmission metrics are presented overall and by expected payer: (1) conditions with the highest number of readmissions, (2) conditions with the highest readmission rate, and (3) conditions with the highest average readmission cost. More information on past program policies and supplemental data files is available in the CMS HRRP Archives. Partner with us; we deliver on our promises. TeamHealth Crystalline Cellulose, How does Johns Hopkins Medicine perform? Real world data on hospital readmissions of patients with heart failure . Data analyses were conducted from March to November 2020. We would urge patients to consider more recent performance in combination with historical performance. JAMA. Trends in Readmissions and Length of Stay for Patients Hospitalized With Heart Failure in Canada and the United States. Cardiovasc Digit Health J. The Centers for Medicare and Medicaid Services (CMS) reports hospital readmission rates for Medicare patients who were admitted to the hospital for heart attack, heart failure, and pneumonia. Many times hospital readmissions can be avoided. Septicemia also had among the highest average . Reductions in payments to all fee-for-service hospitals with excessive readmissions (above the national average) are determined by a payment adjustment factor that caps penalties at up to 3% for all Medicare fee-for-service-based operating diagnosis-related group payments for the fiscal year from 2015 to 2018. Revenue growth will be outpaced by expense growth, which will also weigh on [operating cash flow], the report said. Official websites use .govA These penalties can be costly to a hospital, but their financial issues are exacerbated by the impact of COVID-19 pandemic. According to federal data cited byKaiser Health News, in 2021 CMS will penalize 2,545 hospitals for having too many Medicare patients readmitted within 30 days. HHS Vulnerability Disclosure, Help 12/31/2021: 7/1/2018 - 6/30/2021: 7/1/2020 - 6/30/2021 . In 2018, the average 30-day home health readmission rate across all MS-DRGs checked in at 17.50%, according to the Chartbook. Apr 30, 2021. A survey was administered via print and electronic means to hospital leaders at 588 randomly sampled acute-care hospitals participating in Medicare's Inpatient Prospective Payment System, fielded from November 2020 to June 2021. Overall, 2,545or 83%will face penalties under HRRP in FY 2021, according to KHN. Click to reveal Over the 2018-2020. Limited skills and resources. See how Johns Hopkins Medicine prioritizes safety during the COVID-19 pandemic. Kathy Ward, B.S.N., R.N., A.C.M., C.C.M.Manager of Case Management, Johns Hopkins Bayview Medical Center. Results: The national 30-day rate of readmission after hospital discharge is 15.6 percent, according to the most recent data from CMS' Hospital Compare. Homeless people had higher rates of readmission for diseases of the circulatory system, mental illness, and diseases of the digestive system. Los Angeles, CA 90048. The FY 2021 program includes 30-day risk-standardized unplanned readmission measures for four conditions and two procedures: Acute myocardial infarction (AMI) Chronic obstructive pulmonary disease (COPD) Heart failure (HF) Pneumonia Coronary artery bypass graft (CABG) surgery Based on national trends, which reflect a slowing in readmissions reductions for all Medicare beneficiaries after a number of years of larger declines, CMS has selected a more modest target reduction rate for CY 2021 of 0.25 percent. government site. lock Billings Clinic successfully improved HF care, which has resulted in improved clinical outcomes and substantial cost savings, including: $544K in cost savings, the result of a: 18.6 percent relative reduction in the HF 30-day readmission rate in one yearwith the current readmission rate 13.6 percent lower than the national average. In 2015, COPD readmissions were added to this program. The cost of hospital readmissions is enormous, estimated to be in the vicinity of $26 billion annually (Wilson, 2019), so it's no wonder Medicare is working to reduce this amount. In period July 2011-June 2014, the readmission. A widely cited statistic in the national readmissions debate holds that one in five acute hospital discharges will lead to a readmission within 30 days. In this analysis of a nationally representative administrative data set, for primary HF admissions, crude rates of overall and unique patient hospitalizations declined from 2010 to 2014 followed by an increase from 2014 to 2017. Readmission to the hospital could be for any cause, such as worsening of disease or new conditions. 30-Day Readmission Rates to U.S. on May 27, 2011 56 Leave a comment Filed under Subscription Long-running US soap General Hospital will vanish from Australian screens once again when it ends its run on the W channel on Friday, June 17. According to recent data compiled by the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services, TeamHealth's 30-day hospital readmission rate was only 6.8% - significantly lower than the national benchmark range of 13.9%-20%. 1-800-557-6059 | TTY 711, 24/7. Hospitals by Diagnosis, 2010 and HCUP Statistical Brief #154: Readmissions to U.S. For HF, readmission rates were 23.0% (IQR, 20.6%-25.3%) and 11.4% (IQR, 10.2-12.6%) for days 1-30 and for days 31-60, respectively. This site needs JavaScript to work properly. The maximum penalty for fiscal 2021 is a 3% cut in payment for each Medicare patient, which will affect 39 hospitals. After the Review and Correction period, CMS reports HRRP data in the Inpatient Prospective Payment System/Long-Term Care Hospital Prospective Payment System Final Rule Supplemental Data File on CMS.gov. If a hospital was in more than 1 period, we averaged its readmission rates, weighted by the total discharges in each period. Age trends in unadjusted rates of hospital readmission. PMC Introduction The problem of readmissions to the hospital is receiving increased attention as a potential way to address problems in quality of care, cost of care, and care transitions. The majority of the re-admissions were for CHF followed by renal failure and sepsis. Barriers and Opportunities Regarding Implementation of a Machine Learning-Based Acute Heart Failure Risk Stratification Tool in the Emergency Department. An official website of the United States government. According to the Advisory Board, "In FY 2019, 82% of hospitals in the program received readmissions penalties. 2022 Health of Women and Children Report 2022 Health of Those Who Have Served Report COVID-19 Report 2022 Senior Report 2021 Annual Report 2021 Health Disparities Report 2017 Health of Women Who Have Served View Report Archive. Providers are physicians, advanced practice clinicians and other healthcare providers who are employed by or contract with subsidiaries or affiliated entities of Team Health Holdings, Inc. All such providers exercise independent clinical judgment when providing patient care. CMS will cut payments to the penalized hospitals by as much as 3 percent for each Medicare patient stay during fiscal. The current average represents a slight decrease in all-cause readmission rates. Indicator set: National Healthcare Agreement (2021) Health, Standard 19/11/2020 . AtTeamHealth, our purpose is to perfect the practice of medicine, every day, in everything we do. 21 readmission rates have been considered a hospital quality measure 22, 23 and have been shown to reflect dimensions of quality of patient care. . 17SDG33630113/AHA_/American Heart Association-American Stroke Association/United States, KL2 TR001882/TR/NCATS NIH HHS/United States, eScholarship, California Digital Library, University of California, NCI CPTC Antibody Characterization Program. Federal data from the Centers for Medicare and Medicaid Services (CMS) notes that for the 2021 fiscal year, they are issuing fines to 2,545 hospitals for poor 30-day readmission rates for Medicare patients through the Hospital Readmissions Reduction Program (HRRP). The https:// ensures that you are connecting to the 30-Day Hospital Readmission Rates, Frequencies, and Heart Failure Classification for Patients with Heart Failure. 24, 25 prior studies have discussed the relationship between Overview of the FY 2021 Hospital Readmissions Reduction Program Hosted by: Inpatient Value, Incentives, and Quality Reporting Outreach and Education Support Contractor (Inpatient VIQR SC) August 7, 2020. PI 23-Unplanned hospital readmission rates, 2021: METEOR identifier: 725779: Registration status: Health, Standard 19/11/2020; Description: Unplanned and unexpected hospital readmissions to the same public hospitals within 28 days for selected surgical procedures. 133.242.2.119 Hours. 2018 Sep 7;1(5):e182777. Readmission Rates GEISINGER MEDICAL CENTER 100 North Academy Avenue Danville, PA 17822 Phone: (570) 271-6211 The measures for unplanned readmission at Geisinger Medical Center are estimates of any acute care hospital stay within 30 days from a previous hospitalization discharge. Providers are physicians, advanced practice clinicians and other healthcare providers who are employed by or contract with subsidiaries or affiliated entities of Team Health Holdings, Inc. All such providers exercise independent clinical judgment when providing patient care. Prioritizing innovation, clinical quality and patient safety are major factors in reduced readmission rates that exceed national benchmarks. Join our team; we value and empower clinicians. An analysis from Moody's predicts a negative outlook for not-for-profit hospitals, expected to see major cash flow issues in 2021 due to lower patient volumes, rising expenses and worsening payer mix. Lastly, establishing effective multidisciplinary rounds that leverages the expertise of nursing, therapy, case management and pharmacy is a key component of TeamHealths ability to reduce a patients readmission risk. Results Overall, 15.1 and 47.7% of patients were readmitted within 30 and 365 days, respectively. News Articles Case Studies. This accounts for nearly half of the nation's hospitals, but when one accounts for critical access hospitals or others exempted by Congress, such as those that specialize in psychiatric patients, children, veterans, rehabilitation or long-term care, 83% received a penalty. These nurses ensure that patients are taking their medications correctly, answer any questions the patient may have, and review care instructions, like when to call the doctor. eCollection 2022 Dec. Heart Lung. Your IP: . 2022 Nov 24;58:104-107. doi: 10.1016/j.hrtlng.2022.11.014. This State of Healthcare Quality Report classifies health plans differently than NCQA's Quality Compass. The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions. 1-800-CEDARS-1. We recommend that the vocabulary used in hospital discharge against medical advice policies and documents should be updated to reflect a culture of medicine that values patient autonomy, patient centeredness, and shared decision making. The average penalty this year is 0.69%, which is down from FY 2020's average 0.71% penalty. For-profit hospitals should see volumes recover from 2020 levels, with adjusted admission rates growing around 4% and net revenue per adjusted admission growing 0-1%. Hospitals 30-Day Readmission Rates to U.S. August 11, 2021 09:58 ET According to recent data compiled by the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services, TeamHealth's 30-day hospital readmission rate was only. It was only eight years ago, when New Jersey hospitals delivered more than one-third of all babies surgically, a staggering c-section rate of 38.8 percent. Top 3 Barriers of Healthcare Interoperability . Performance & security by Cloudflare. 2022 Dec 15;3(6 Suppl):S9-S16. Hospitals by Procedure, 2010. Hospital Readmissions Reduction Program (HRRP) Program Lead. This is a pay-for-performance program that reduces payments to hospitals with excess readmissions. More than 4,500 hospitals were eligible to receive star ratings. Pharmacists can visit patient rooms for extra instruction about high-risk conditions and the drugs used for treatment. national hospital readmission rates 2021 vmanage cluster disaster recovery . The 30 day unplanned readmission rate following all US index admissions was 11.6% (n=3 678 018). Team Health Holdings, Inc., does not have any employees, does not contract with providers and does not practice medicine. Results Overall, 15.1 and 47.7% of patients were readmitted within 30 and 365 days, respectively. In period July 2011-June 2014, the readmission. Over the 2018-2020 time period, readmission rates across TeamHealth client sites declined by 15%. Explore Data. The national benchmark is based on data compiled by AHRQs Healthcare Cost and Utilization Project from 2010-2016 and CMS from 2018-2020. While some readmissions are unavoidable, many can be prevented with the right support, including Locum Tenens clinicians. Plan All-Cause Readmissions (PCR) Assesses the rate of adult acute inpatient and observation stays that were followed by an unplanned acute readmission for any diagnosis within 30 days after discharge among commercial (18 to 64), Medicaid (18 to 64) and Medicare (18 and older) health plan members. New York had the lowest at 15.7% vs. 13.4% for housed individuals. By Nick Hut. Apr 30, 2021. Using this approach, hospitals have seen as much as an 85% reduction in unnecessary hospital readmissions for conditions such as congestive heart failure, atrial fibrillation, COPD and even lumbar spinal fusion surgery. Faaborg-Andersen CC, daSilva-deAbreu A, Ventura HO. News Articles Case Studies. Data Infographics 30-Day Readmission Rates to U.S. Any Health System 2018 Performance Rank Percentiles 0.0 20.0 40.0 60.0 80.0 100.0 OVERALL Inpt Mort Comp HAI IMM 30Day Mort 30Day H-W Readmit ALOS ED Meas MSPB HCAHPS Findings This cohort study of 8 273 270 HF hospital admissions from January 2010 to December 2017 showed that the rates for . To make the patients transition plan from the hospital successful, I conduct a full medical, social and financial assessment, and coordinate with several key players, including home health services, financial counseling and community agencies. The program supports the national goal of improving health care for Americans by linking payment to the quality of . As age at index admission increased from 0 to 90+ years, the unadjusted 30 day readmission rate increased from 2.4% (94 075/3 843 084) to 15.3% (155 104/1 011 373) (P<0.001) ( fig 1 ). Hospitals (PDF, 437 KB) Source: HCUP Statistical Brief #153: Readmissions to U.S. With a focus on healthcare transparency, performance reporting in the hospital & health care industry, AHRQ Stats: Highest Hospital Readmission Rate, Overview of Clinical Conditions With Frequent and Costly Hospital Readmissions by Payer, 2018, Healthcare Cost and Utilization Project Statistical Brief #278: Overview of Clinical Conditions With Frequent and Costly Hospital Readmissions by Payer, 2018, Minnesota Health Care Quality Report: Results for Care Delivered in 2021, Joint Commission Elevates Health Care Equity Standard to National Patient Safety Goal, Study Finds Nearly 1 in 4 Hospital Admissions Experience Harmful Events, Health Affairs Study Examines Relationship Between Star Rating Scores and Hospitals Proportion of Medicare Patients Dually Eligible for Medicaid, Healthcare Experts Call for Greater Transparency in Cost, Quality in Healthcare Industry. Readmission Rates for Chronic Obstructive Pulmonary Disease Under the Hospital Readmissions Reduction Program: an Interrupted Time Series Analysis Readmission Rates for Chronic Obstructive Pulmonary Disease Under the Hospital Readmissions Reduction Program: an Interrupted Time Series Analysis Indicator set: National Healthcare Agreement (2021) Health, Standard 19/11/2020 . The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions. The Centers for Medicare and Medicaid Services (CMS) reports hospital readmission rates for Medicare patients who were admitted to the hospital for heart attack, heart failure, and pneumonia. Int J Cardiol. the National Committee for Quality Assurance, Center for Health Care Strategies, AcademyHealth, and Aurrera Health Group. This would be particularly true if hospitals continue to see high levels of COVID-19 hospitalizations in 2021., Akin Demehin, director of policy at the American Hospital Association, added, "It's unfortunate that hospitals will face readmission penalties in fiscal year 2021. The .gov means its official. Figure.. Only 52 facilities that performed poorly at baseline (0.3% of all SNFs and 0.7% of below-median performers) were able to improve enough to avoid a financial penalty, despite large improvements in readmission rates. Outdated legacy systems. Objectives: Clin Drug Investig. My Location *. National Average ---19.8: 11.9: 15: 21.3: 4.1 ---State Average: 8.7: 19.5: 11.6: 14.7 . An official website of the United States government Specific aims include comparing computed annual readmission rates with national average, determine the number of multiple 30-day readmissions, provide descriptive . Readmission Rates Value of Care The following top hospitals have hospital wide unplanned readmission rates better than the national average rate. The expected payer and condition (principal diagnosis) are based on the index admission. 8 Of these, 1167 (63.1%) received a financial penalty, whereas 374 (20.2%) received a bonus. Given the financial strain that hospitals are under, every dollar counts, and the impact of the penalty is significant.". In 2018, there were 3.8 million 30-day all-cause adult hospital readmissions, with a 14 percent readmission rate and an average readmission cost of $15,200. Siderite Thin Section. Access to community resources and family support can impact the chances that a patient returns to the hospital. The collaboration we enjoy with our partner hospitals, as well as our data-driven approach and culture of continuous improvement makes these results possible.. The indicators presented measure the percentage of emergency admissions to any hospital in England occurring within 30 days of the last, previous discharge from hospital over the period 2013/14 to 2020/21. Only 52 facilities that performed poorly at baseline (0.3% of all SNFs and 0.7% of below-median performers) were able to improve enough to avoid a financial penalty, despite large improvements in readmission rates. Section 1886(q) of the Social Security Act sets forth the statutory requirements for HRRP, which required the Secretary of the U.S. Department of Health and Human Services to reduce payments to subsection (d) hospitals for excess readmissions beginning October 1, 2012 (that is, fiscal year [FY] 2013). Over the 2018-2020 time period, readmission rates across TeamHealth client sites declined by 15%. Page last reviewed August 2018 Page originally created August 2018 From 2010 to 2013, primary hospitalizations declined almost 7.0%, from 4.4 to 4.1, before rising once again almost 17.0% between 2014 and 2017, from 4.2 to 4.9 (all rates were calculated per 1000. Find & compare nursing homes, hospitals & other providers near you. Association of the Hospital Readmissions Reduction Program With Mortality During and After Hospitalization for Acute Myocardial Infarction, Heart Failure, and Pneumonia. Reducing unnecessary hospital readmissions can help deaden the negative financial impact facing hospitals, not to mention improve health outcomes for the millions of patients who would benefit. The Nationwide Readmissions Database (NRD) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP).The NRD is a unique and powerful database designed to support various types of analyses of national readmission rates for all patients, regardless of the expected payer for the hospital stay. The legislation requires estimated payments under the peer grouping methodology (that is, FY 2019 and onward) equal payments under the non-peer grouping methodology (that is, FY 2013 to FY 2018) to maintain budget neutrality. JAMA Cardiol. .gov US Trends for Overall Heart Failure (HF) Hospitalizations, Unique Patient Visits, and Postdischarge HF, MeSH Volume 50, Issue 4, July-August 2021, Page 562. 2 Nov, 2022 aries horoscope today astroyogi jumble crossword clue 8 letters amorphous tio2 refractive index. . Conclusions and relevance: In this analysis of a nationally representative administrative data set, for primary HF admissions, crude rates of overall and unique patient hospitalizations declined from 2010 to 2014 followed by an increase from 2014 to 2017. The payment reduction is capped at 3 percent (that is, a payment adjustment factor of 0.97). Overall, hospital readmission rates varied from 17.4% in 2010 to 2013 to 16.7% in 2017 to 2019. Sign up today for your free Reader Account. . May 4, 2018 This statistic displays the National hospital readmission rate under Medicare from 2005 to 2014, by initial hospitalization diagnosis. ( 2009 ). We are vaccinating all eligible patients. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. Before National Trends in Heart Failure Hospitalization and Readmissions Associated With Policy Changes-Reply. Readmission Rate (18-64 Years)* Readmission Rate (65 Years and Older)* Not available due to CMS suspension of data reporting during COVID-19 pandemic. sharing sensitive information, make sure youre on a federal Limited data exist regarding trends of HF readmission rates beyond 30 days from all-payer sources. As KHN reports, " [b]ecause the penalties are applied to new admission payments, the total dollar amount each hospital will lose will not be known until after the [FY] ends." Hospitals (PDF, 437 KB) Source: HCUP Statistical Brief #153: Readmissions to U.S. Also of note: The 30-day readmission rate across all MS-DRGs was also exactly 17.50% for skilled nursing, compared to a 2017 mark of 17.41%. national hospital readmission rates 2021. The payment reduction is capped at 3 percent (that is, a payment adjustment factor of 0.97). (CY) 2021 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS-1736-P). Key Points. Index admissions for cancer and cancer-related therapies are included in overall readmission statistics but are not reported in condition-specific statistics. The Nationwide Readmissions Database (NRD) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP).The NRD is a unique and powerful database designed to support various types of analyses of national readmission rates for all patients, regardless of the expected payer for the hospital stay. There were 8 273 270 primary HF hospitalizations with a single primary HF admission present in 5 092 626 unique patients, and 1 269 109 had 2 or more HF hospitalizations. Many Johns Hopkins hospitals have special pharmacy programs that provide bedside delivery for discharge medications. 2. Beating the national benchmark for 30-day readmissions by over 50% establishes our hospitalists as leaders in the industry and tells patients and hospitals that we are only satisfied with the best possible outcomes for the people and communities we serve., I could not be more proud and happy for our hospitalists and clinical leaders, said TeamHealth Chief Clinical Officer for Hospitalist Services, Dr. Rohit Uppal. royal winter fair board of directors, symbols to replace curse words, nigel sharrocks conservative, ; 42 ( 12 ):1025-1030. doi: 10.1007/s40261-022-01220-z to 2013 to 16.7 % 2010... And 47.7 % of patients with Heart Failure and coronary artery disease payment for each Medicare patient Stay during.... 018 ) outpaced by expense growth, which is down from FY 2020 's 0.71! 8 letters amorphous tio2 refractive index results overall, hospital readmission rates that exceed national benchmarks Aba Keywords... 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