John S. Hughes

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Executive Summary. OnTo Knowledge , the European EU-IST project No. 10132, builds an ontology-based tool environment to speed up knowledge management, dealing with the large numbers of heterogeneous, distributed, and semi-structured documents typically found in large company intranets and the WorldWide Web. Results aimed for by the project are: (1) a(More)
The potentially preventable readmission (PPR) method uses administrative data to identify hospital readmissions that may indicate problems with quality of care. The PPR logic determines whether the reason for readmission is clinically related to a prior admission, and therefore potentially preventable. The likelihood of a PPR was found to be dependent on(More)
This article describes the development of Potentially Preventable Complications (PPCs), a new method that uses a present on admission (POA) indicator to identify in-hospital complications among secondary diagnoses that arise after admission. Analyses that used PPCs to obtain risk-adjusted complication rates for California hospitals showed that (1) the POA(More)
Under the Medicare diagnosis-related group (DRG) based inpatient prospective payment system (IPPS), payments to hospitals can increase when a post-admission complication occurs. This article proposes a redesign of IPPS that reduces, but does not eliminate, the increase in payment due to post-admission complications. Using California data that contained a(More)
A redesign of the Medicare inpatient prospective payment system (IPPS) that reduces payments to hospitals that have high-risk adjusted readmission rates is proposed. The redesigned IPPS uses a readmission performance standard from best practice hospitals to determine the risk-adjusted number of excess readmissions in a hospital and determines the payment(More)
We investigate the effects of private information and diversification on risk premiums in a noisy rational expectations model in which risky asset payoffs have a factor structure. Information in our model is composed of private signals that are informative about both systematic factors and idiosyncratic shocks. Taking the large economy limit, we show that(More)
Clinical risk-adjustment, the ability to standardize the comparison of individuals with different health needs, is based upon 2 main alternative approaches: regression models and clinical categorical models. In this article, we examine the impact of the differences in the way these models are constructed on end user applications.
Payment reforms aimed at linking payment and quality have largely been based on the adherence to process measures. As a result, the attempt to pay for value is getting lost in an overly complex attempt to measure value. The "Incentivizing Health Care Quality Outcomes Act of 2014" (HR 5823) proposes to replace the existing patchwork of process and outcomes(More)
We consider a firm's design of its financial reporting system when the firm incurs a significant loss if it does not meet a crucial threshold. If the financial reports were the only basis for updating beliefs by the outside party responsible for applying the threshold, the firm's problem would fall into a class of sender-receiver games referred to as(More)