The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994)
Adverse or favorable selection bias exhibited by insurers or enrollees resulting in disproportionate enrollment of certain groups of people.
A method of payment for health services in which an individual or institutional provider is paid a fixed, per capita amount without regard to the actual number or nature of services provided to each patient.
Alternative health care delivery mechanisms, such as PREFERRED PROVIDER ORGANIZATIONS or other health insurance services or prepaid plans (other than HEALTH MAINTENANCE ORGANIZATIONS), that meet Medicare qualifications for a risk-sharing contract. (From Facts on File Dictionary of Health Care Management, 1988)
A method of examining and setting levels of payments.
The discipline concerned with using the combination of conventional ALLOPATHIC MEDICINE and ALTERNATIVE MEDICINE to address the biological, psychological, social, and spiritual aspects of health and illness.
A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.
Hospital department responsible for the flow of patients and the processing of admissions, discharges, transfers, and also most procedures to be carried out in the event of a patient's death.
A component of the Department of Health and Human Services to oversee and direct the Medicare and Medicaid programs and related Federal medical care quality control staffs. Name was changed effective June 14, 2001.
Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.
Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).
The assignment, to each of several particular cost-centers, of an equitable proportion of the costs of activities that serve all of them. Cost-center usually refers to institutional departments or services.
A strategy for purchasing health care in a manner which will obtain maximum value for the price for the purchasers of the health care and the recipients. The concept was developed primarily by Alain Enthoven of Stanford University and promulgated by the Jackson Hole Group. The strategy depends on sponsors for groups of the population to be insured. The sponsor, in some cases a health alliance, acts as an intermediary between the group and competing provider groups (accountable health plans). The competition is price-based among annual premiums for a defined, standardized benefit package. (From Slee and Slee, Health Care Reform Terms, 1993)
The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.
Hospitals providing medical care to veterans of wars.
Adaptation of the person to the social environment. Adjustment may take place by adapting the self to the environment or by changing the environment. (From Campbell, Psychiatric Dictionary, 1996)
Method of measuring performance against established standards of best practice.
Statistical formulations or analyses which, when applied to data and found to fit the data, are then used to verify the assumptions and parameters used in the analysis. Examples of statistical models are the linear model, binomial model, polynomial model, two-parameter model, etc.
Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
A system of categories to which morbid entries are assigned according to established criteria. Included is the entire range of conditions in a manageable number of categories, grouped to facilitate mortality reporting. It is produced by the World Health Organization (From ICD-10, p1). The Clinical Modifications, produced by the UNITED STATES DEPT. OF HEALTH AND HUMAN SERVICES, are larger extensions used for morbidity and general epidemiological purposes, primarily in the U.S.
Institutions with an organized medical staff which provide medical care to patients.
Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)
Method of charging whereby a physician or other practitioner bills for each encounter or service rendered. In addition to physicians, other health care professionals are reimbursed via this mechanism. Fee-for-service plans contrast with salary, per capita, and prepayment systems, where the payment does not change with the number of services actually used or if none are used. (From Discursive Dictionary of Health Care, 1976)
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.
Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
Extraction of the FETUS by means of abdominal HYSTEROTOMY.
Surgery performed on the heart.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Maladaptive reactions to identifiable psychosocial stressors occurring within a short time after onset of the stressor. They are manifested by either impairment in social or occupational functioning or by symptoms (depression, anxiety, etc.) that are in excess of a normal and expected reaction to the stressor.
Components of a national health care system which administer specific services, e.g., national health insurance.
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
The period of confinement of a patient to a hospital or other health facility.
Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.
An infant during the first month after birth.
Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth.
The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources.
The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.
Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
Elements of limited time intervals, contributing to particular results or situations.
The confinement of a patient in a hospital.
The concept concerned with all aspects of providing and distributing health services to a patient population.

Risk-adjusted capitation based on the Diagnostic Cost Group Model: an empirical evaluation with health survey information. (1/409)

OBJECTIVE: To evaluate the predictive accuracy of the Diagnostic Cost Group (DCG) model using health survey information. DATA SOURCES/STUDY SETTING: Longitudinal data collected for a sample of members of a Dutch sickness fund. In the Netherlands the sickness funds provide compulsory health insurance coverage for the 60 percent of the population in the lowest income brackets. STUDY DESIGN: A demographic model and DCG capitation models are estimated by means of ordinary least squares, with an individual's annual healthcare expenditures in 1994 as the dependent variable. For subgroups based on health survey information, costs predicted by the models are compared with actual costs. Using stepwise regression procedures a subset of relevant survey variables that could improve the predictive accuracy of the three-year DCG model was identified. Capitation models were extended with these variables. DATA COLLECTION/EXTRACTION METHODS: For the empirical analysis, panel data of sickness fund members were used that contained demographic information, annual healthcare expenditures, and diagnostic information from hospitalizations for each member. In 1993, a mailed health survey was conducted among a random sample of 15,000 persons in the panel data set, with a 70 percent response rate. PRINCIPAL FINDINGS: The predictive accuracy of the demographic model improves when it is extended with diagnostic information from prior hospitalizations (DCGs). A subset of survey variables further improves the predictive accuracy of the DCG capitation models. The predictable profits and losses based on survey information for the DCG models are smaller than for the demographic model. Most persons with predictable losses based on health survey information were not hospitalized in the preceding year. CONCLUSIONS: The use of diagnostic information from prior hospitalizations is a promising option for improving the demographic capitation payment formula. This study suggests that diagnostic information from outpatient utilization is complementary to DCGs in predicting future costs.  (+info)

Dissociable deficits in the decision-making cognition of chronic amphetamine abusers, opiate abusers, patients with focal damage to prefrontal cortex, and tryptophan-depleted normal volunteers: evidence for monoaminergic mechanisms. (2/409)

We used a novel computerized decision-making task to compare the decision-making behavior of chronic amphetamine abusers, chronic opiate abusers, and patients with focal lesions of orbital prefrontal cortex (PFC) or dorsolateral/medial PFC. We also assessed the effects of reducing central 5-hydroxytryptamine (5-HT) activity using a tryptophan-depleting amino acid drink in normal volunteers. Chronic amphetamine abusers showed suboptimal decisions (correlated with years of abuse), and deliberated for significantly longer before making their choices. The opiate abusers exhibited only the second of these behavioral changes. Importantly, both sub-optimal choices and increased deliberation times were evident in the patients with damage to orbitofrontal PFC but not other sectors of PFC. Qualitatively, the performance of the subjects with lowered plasma tryptophan was similar to that associated with amphetamine abuse, consistent with recent reports of depleted 5-HT in the orbital regions of PFC of methamphetamine abusers. Overall, these data suggest that chronic amphetamine abusers show similar decision-making deficits to those seen after focal damage to orbitofrontal PFC. These deficits may reflect altered neuromodulation of the orbitofrontal PFC and interconnected limbic-striatal systems by both the ascending 5-HT and mesocortical dopamine (DA) projections.  (+info)

Evaluating and improving the delivery of heart care: the University of Michigan experience. (3/409)

With increasing pressure to curb escalating costs in medical care, there is particular emphasis on the delivery of cardiovascular services, which account for a substantial portion of the current healthcare dollar spent in the United States. A variety of tools were used to improve performance at the University of Michigan Health System, one of the oldest university-affiliated hospitals in the United States. The tools included initiatives to understand outcomes after coronary bypass operations and coronary angioplasty through use of proper risk-adjusted models. Critical pathways and guidelines were implemented to streamline care and improve quality in interventional cardiology, management of myocardial infarction, and preoperative assessment of patients undergoing vascular operations. Strategies to curb unnecessary costs included competitive bidding of vendors for expensive cardiac commodities, pharmacy cost reductions, and changes in nursing staff. Methods were instituted to improve guest services and partnerships with the community in disease prevention and health promotion.  (+info)

Health-based payment and computerized patient record systems. (4/409)

Health care information technology is changing rapidly and dramatically. A small but growing number of clinicians, especially those in staff and group model HMOs and hospital-affiliated practices, are automating their patient medical records in response to pressure to improve quality and reduce costs. Computerized patient record systems in HMOs track risks, diagnoses, patterns of care, and outcomes across large populations. These systems provide access to large amounts of clinical information; as a result, they are very useful for risk-adjusted or health-based payment. The next stage of evolution in health-based payment is to switch from fee-for-service (claims) to HMO technology in calculating risk coefficients. This will occur when HMOs accumulate data sets containing records on provider-defined disease episodes, with every service linked to its appropriate disease episode for millions of patients. Computerized patient record systems support clinically meaningful risk-assessment models and protect patients and medical groups from the effects of adverse selection. They also offer significant potential for improving quality of care.  (+info)

Risk-adjusted outcome models for public mental health outpatient programs. (5/409)

OBJECTIVE: To develop and test risk-adjustment outcome models in publicly funded mental health outpatient settings. We developed prospective risk models that used demographic and diagnostic variables; client-reported functioning, satisfaction, and quality of life; and case manager clinical ratings to predict subsequent client functional status, health-related quality of life, and satisfaction with services. DATA SOURCES/STUDY SETTING: Data collected from 289 adult clients at five- and ten-month intervals, from six community mental health agencies in Washington state located primarily in suburban and rural areas. Data sources included client self-report, case manager ratings, and management information system data. STUDY DESIGN: Model specifications were tested using prospective linear regression analyses. Models were validated in a separate sample and comparative agency performance examined. PRINCIPAL FINDINGS: Presence of severe diagnoses, substance abuse, client age, and baseline functional status and quality of life were predictive of mental health outcomes. Unadjusted versus risk-adjusted scores resulted in differently ranked agency performance. CONCLUSIONS: Risk-adjusted functional status and patient satisfaction outcome models can be developed for public mental health outpatient programs. Research is needed to improve the predictive accuracy of the outcome models developed in this study, and to develop techniques for use in applied settings. The finding that risk adjustment changes comparative agency performance has important consequences for quality monitoring and improvement. Issues in public mental health risk adjustment are discussed, including static versus dynamic risk models, utilization versus outcome models, choice and timing of measures, and access and quality improvement incentives.  (+info)

Anthem Blue Cross and Blue Shield's coronary services network: a managed care organization's approach to improving the quality of cardiac care for its members. (6/409)

OBJECTIVE: To describe a managed care organization's efforts to improve value for its members by forming a coronary services network (CSN). DESIGN: To identify high-quality facilities for its CSN, Anthem Blue Cross and Blue Shield reviewed claims data and clinical data from hospitals that met its general quality standards. An external firm measured and risk-adjusted applicant hospitals' mortality rates. Hospitals that demonstrated superior performance were eligible to join the CSN. In 1996, 2 years after the CSN was formed, clinical outcomes of participants and new applicants were analyzed again by the same external firm. PATIENTS AND METHODS: Data on more than 10,000 consecutive (all-payer) inpatients discharged after coronary bypass surgery in 1993 were collected from 16 applicant hospitals using a uniform format and data definitions. This analysis was expanded to 23 participating and applicant hospitals that discharged more than 13,000 patients who underwent either bypass surgery or coronary revascularization in 1995. We compared risk-adjusted routine length of stay (a measure of efficiency), mortality rates, and adverse outcome rates between CSN and non-CSN facilities. RESULTS: From 1993 to 1995, overall length of stay in the network decreased by 20%, from 12.3 to 9.8 days (P < or = 0.01) and severity-adjusted mortality rates decreased by 7.3%, from 2.9% to 2.7%. Initially, facilities outside the network had comparable efficiency but much higher mortality. However, they improved so much in both measures that their severity-adjusted mortality rate for bypass surgery in 1995 was no more than 10% higher than that of CSN hospitals. CONCLUSION: The creation of a statewide CSN that emphasized and improved the level of performance among providers ultimately benefited the carrier's managed care members. The desirability of participation was evidenced by an increase in the number of applicant hospitals over the 2 years. This may have stimulated quality improvement among competing providers in the region and among CSN facilities themselves.  (+info)

Comparing AMI mortality among hospitals in patients 65 years of age and older: evaluating methods of risk adjustment. (7/409)

BACKGROUND: Interest in the reporting of risk-adjusted outcomes for patients with acute myocardial infarction is growing. A useful risk-adjustment model must balance parsimony and ease of data collection with predictive ability. METHODS AND RESULTS: From our analysis of 82 359 patients >/=65 years of age admitted with acute myocardial infarction to 2401 hospitals, we derived a parsimonious model that predicts 30-day mortality. The model was validated on a similar group of 78 699 patients from 2386 hospitals. Of the 73 candidate predictor variables examined, 7 variables describing patient characteristics on arrival were selected for inclusion in the final model: age, cardiac arrest, anterior or lateral location of myocardial infarction, systolic blood pressure, white blood cell count, serum creatinine, and congestive heart failure. The area under the receiver-operating characteristic curve for the final model was 0.77 in the derivation cohort and 0.77 in the validation cohort. The rankings of hospitals by performance (in deciles) with this model were most similar to a comprehensive 27-variable model based on medical chart review and least similar to models based on administrative billing codes. CONCLUSIONS: A simple 7-variable risk model performs as well as more complex models in comparing hospital outcomes for acute myocardial infarction. Although there is a continuing need to improve methods of risk adjustment, our results provide a basis for hospitals to develop a simple approach to compare outcomes.  (+info)

Case mix adjustment in nursing systems research: the case of resident outcomes in nursing homes. (8/409)

Case mix indicates, for a resident population, the degree of risk for developing favorable or unfavorable outcomes. In a study of 164 nursing homes, we explored two methods for combining resident assessment data into a case mix index (CMI). We compared a facility-level, composite CMI to a prevalence-based CMI comprised of 22 separate resident characteristics for their adequacy in explaining resident outcomes. The prevalence-based CMI consistently explained more variance in outcomes than the facility level, composite CMI. This study indicates a reasonable method for using administrative databases containing resident assessment data to adjust for the influence of case mix on nursing home resident outcomes.  (+info)

As the emphasis in health reform shifts to value-based payments, especially through multi-payer initiatives supported by the U.S. Center for Medicare & Medicaid Innovation, and with the increasing availability of statewide all-payer claims databases, the need for an all-payer,
Under this system, healthcare providers take responsibility for much of the financial risk that may arise from providing health services to patients.10 Because the total number of patients enrolled with a healthcare provider may be relatively small, the threat of adverse selection (registering patients who use considerably more healthcare resources than covered by their capitation payment) is great. For example, the 10% of Medicaid enrolees who make the most use of resources account for around 70% of all Medicaid payments.11 Consequently, without some method of risk adjustment of payments, healthcare providers will compete to attract healthy patients who are unlikely to make much use of their services. Sicker patients may find it difficult to find a healthcare provider who is willing to register them.. To overcome this problem, diagnosis based risk adjustment models have been developed to modify the payments made to health maintenance organisations and health plans. For example, the US Federal ...
January 2012. TO: Members of Actuarial Organizations Governed by the Standards of Practice of the Actuarial Standards Board and Other Persons Interested in the Use of Health Status Based Risk Adjustment Methodologies. FROM: Actuarial Standards Board (ASB). SUBJ: Actuarial Standard of Practice (ASOP) No. 45. This document contains the final version of ASOP No. 45, The Use of Health Status Based Risk Adjustment Methodologies.. Background. Health status based risk adjustment methodologies have been an important tool in the health insurance marketplace since the 1970s. The use of risk adjustment has significant effects on health insurance companies, healthcare providers, consumers, employers and others. The importance and influence of health status based risk adjustment methodologies are likely to increase as healthcare programs that currently use risk adjustment expand the populations they cover and other programs adopt the use of risk adjustment. ASOP No. 12, Risk Classification (for All Practice ...
Risk Adjustment and Hierarchical Condition Category (HCC) coding is a payment model mandated by the Centers for Medicare and Medicaid Services (CMS) in 1997. Implemented in 2003, this model identifies individuals suffering from chronic illness and assigns a risk factor score to the person based upon a combination of the individuals health conditions and demographic details. The individuals health conditions are identified through the International Classification of Diseases -10 cm (ICD -10cm) diagnoses that are submitted by providers on incoming claims. There are more than 9000 ICD-10 codes that map to 79 HCC codes in the Risk Adjustment model.
The increasing number of geriatric trauma patients in developed countries is a preoccupation at every stage in the continuum of trauma care. In the acute care setting, elderly patients require specific care strategies and patient outcome may be compromised by varying degrees of dedication to geriatric trauma across hospitals. We hypothesised that the performance of trauma centres in the population of geriatric patients differs to that among young adults. Analyses were based on the evaluation of hospital mortality across the 59 trauma centres of the inclusive trauma system in the province of Quebec, Canada (1999-2006). Trauma centre evaluation was based on estimates of risk-adjusted mortality generated using a random-intercept hierarchical logistic regression model. Adjustment was performed with a risk score generated by the Trauma Risk Adjustment Model. Results for young adults (16-64 years) and geriatric patients (≥65 years) were compared using hospital ranks and outliers. Among the 55 355 ...
TY - JOUR. T1 - Comparative Performance of Diagnosis-based and Prescription-based Comorbidity Scores to Predict Health-related Quality of Life. AU - Mehta, Hemalkumar. AU - Sura, Sneha D.. AU - Sharma, Manvi. AU - Johnson, Michael L.. AU - Riall, Taylor S.. PY - 2016/2/25. Y1 - 2016/2/25. N2 - OBJECTIVES:: To compare the performance of the health-related quality of life-comorbidity index (HRQoL-CI) with the diagnosis-based Charlson, Elixhauser, and combined comorbidity scores and the prescription-based chronic disease score (CDS) in predicting HRQoL in Agency of Healthcare Research and Quality priority conditions (asthma, breast cancer, diabetes, and heart failure). METHODS:: The Medical Expenditure Panel Survey (2005 and 2007-2011) data was used for this retrospective study. Four disease-specific cohorts were developed that included adult patients (age 18 y and above) with the particular disease condition. The outcome HRQoL [physical component score (PCS) and mental component score (MCS)] was ...
Alessandrini, E. A., Alpern, E. R., Chamberlain, J. M., Shea, J. A., Holubkov, R., & Gorelick, M. H. (2012). Developing a diagnosis-based severity classification system for use in emergency medical services for children. Academic Emergency Medicine, 19(1), 70-78.. ...
This page contains the abstract A Theoretical Model For The Development Of A Diagnosis-based Clinical Decision Rule For The Management Of Patients With Spinal Pain http://www.chiro.org/LINKS/ABSTRACTS/A_Theoretical_Model_For_The_Development.shtml
This study uses national Medicare data as well as data that were abstracted to calibrate the Medicare Mortality Predictor System to assess the usefulness of a risk adjustment system in interpreting hospital mortality rates. The majority of variation in annual hospital death rates for the four condit …
Assessing urinary flow rate, creatinine, osmolality and other hydration adjustment methods for urinary biomonitoring using NHANES arsenic, iodine, lead and cadmium data
We compared the performance of the Charlson and the Elixhauser comorbidity measures in predicting short and long term mortality among patients with CHF, diabetes, CRF, stroke, and CABG between ICD-9 and ICD-10 Canadian hospital discharge abstract databases. We found that most comorbidities studied had similar frequencies across ICD-9 and ICD-10 databases although variations were observed for some comorbidities. The performance of the Charlson and Elixhauser comorbidity measures in discriminating mortality was similar in ICD-9 data as well as ICD-10 data across five study cohorts.. In the patients with CHF and stroke, the C-statistic values for the predicting in-hospital or 1 year mortality were notably low with values of 0.63 and 0.66 for CHF and 0.62 and 0.67 for stroke, respectively. The low values might reflect the fact that some powerful clinical predictors of poor outcomes were not included in these measures due to a lack of information in the administrative databases, such as ejection ...
All OptumCare Risk Adjustment Healthcare jobs in United States. Juju searches jobs from 1,000s of sites to make your OptumCare Risk Adjustment Healthcare job search faster and more comprehensive.
The rates of postoperative sepsis and deep vein thrombosis/pulmonary embolism (DVT/PE) are the two outcome markers for safe surgery. The rates have fluctuated over time. To understand the factors driving the changes and to provide risk-adjusted outcomes in the monitoring and improvement of surgical QSMs, we have developed a risk-adjustment model for these two outcome markers.. The model identifies how likely patients being operated on were to develop sepsis or DVT/PE based on factors such as their condition, health history and the operation being undertaken. From this, we calculated how many patients would be predicted to develop sepsis or DVT/PE based on historic trends. We then compare how many patients actually developed sepsis or DVT/PE to create an observed/expected (O/E) ratio. If the O/E ratio is more than 1 then there are more sepsis or DVT/PE cases than expected, even when patient risk is taken into account. A ratio of less than 1 indicates fewer sepsis or DVT/PE cases than ...
To compare how well hierarchical condition categories (HCC) and probability of repeated admission (PRA) scores predict hospitalization. Longitudinal cohort study with 12-month follow-up. A Medicare Advantage (MA) plan. Four thousand five hundred six newly enrolled beneficiaries. HCC scores were...
The Unison modular flex guide rail adjustment system is designed to reduce the amount of time spent changing guide rails on conveyor systems.
Results: The 10 best algorithms had a mean raw sensitivity of 59.4% and a mean specificity of 95.1%. Adjustment for overrepresentation of patients in the first quarter year of infection further reduced the sensitivity. In the preferred model, the mean adjusted sensitivity was 37.4%. Application of the 10 best algorithms to four annual cohorts of HIV-1 notifications totalling 2595 patients yielded a mean IIR of 0.35 in 2005/6 (baseline) and of 0.45, 0.42 and 0.35 in 2008, 2009 and 2010, respectively. The increase between baseline and 2008 and the ensuing decreases were highly significant. Other adjustment models yielded different absolute IIR, although the relative changes between the cohorts were identical for all ...
1 Introduction. Research Questions. Empirical Focus. Theoretical Argument. About the Cases. Structure of the Book. References. 2 Making and Changing Policies. Making Policies. Problem Definition and Agenda Setting. Policy Drafting and Adoption. Policy Implementation. Policy Evaluation. Scientific Evidence in the Making of Policies. Changing Policies. Defining Policy Change. Explaining Policy Change. Subsystem Adjustment Model. Agenda Setting and Policy Change. Changing Precautionary Policies. Conclusion. References. 3 Review of the Regulatory Context. Introduction. European Union: Actors, Institutions, and Decision Making. Political System of the European Union. Types of European Law. Policy Making in the European Union. Agenda Setting and Drafting. Adoption. Implementation. World Trade Organization. Conclusion. References. 4 Perspectives on the Precautionary Principle. General Characteristics of the Precautionary Principle. Risk and Uncertainty. Main Interpretations. Application Through Policy ...
This chapter analyses the drivers of individual attitudes towards skilled immigration, looking at how preferences towards overall and skilled immigration change depending on the relative skill composition of the native vs. immigrant population. The chapter finds that more educated natives are less likely to favour high educational qualifications of migrants across several countries-consistent with the labour market channel-while richer individuals are more likely to-consistent with the welfare state channel under the tax adjustment model. The chapter then considers how individual preferences can be aggregated into policy outcomes in a democratic society by using a median voter model and a framework in which policy outcomes are instead the result of lobbying efforts by organized groups. The chapter does not find evidence consistent with the median voter model, but it shows that interest groups are actively engaged and effective in affecting policies towards skilled migrants.
We appreciate Dr Lehmanns supportive comments on our articles1,2 in Circulation. Dr Lehmann also brings up a relevant question: Why did we not include QRS duration as a covariate in our QT adjustment models?. This question was examined in some detail in previous publications.3,4 Adding the QRS interval as a covariate with the R-R interval did not increase the R2 value in men, and it increased by less than 1% in women.. What is the reason for this seemingly counterintuitive paradox? The QT interval is, without exception, the sum of the excitation time and the action potential duration of the myocardial cells in the region repolarizing last. This region is excited in normal conduction during the initial half of the QRS interval because repolarization sequence is semireverse with respect to depolarization; therefore, its excitation time is perhaps smaller than expected. Excitation times in the so called incomplete bundle-branch blocks(QRS ,120 ms) vary.5 The significance of the QRS contribution ...
The major limitation of risk adjustment is that it can only account for measurable and reported risk factors. Unfortunately, many important risk factors for adverse patient outcomes are either not measurable using available data (e.g., preoperative functional status) or are not consistently reported (e.g., obesity). For some outcome measures, such as heart attack mortality at the hospital level, classification of hospital performance is reasonably robust despite these immeasurable or unreported factors, because between-hospital variation in outcomes is relatively large.87,88 In addition, unmeasured risk factors tend to be randomly distributed across hospitals.89 For other outcome measures, the limitations of risk adjustment are likely to be more problematic, particularly at the physician level, due to clustering of certain types of patients in certain physicians practices.. Another problem with risk-adjusted outcomes is that they are often misinterpreted. Most risk-adjustment approaches involve ...
Therefore, it is crucial to identify as precisely as possible patients most likely to benefit from these programs. Finding high-risk patients in computerized medical record systems, using predictive modelling, has been evaluated in care management trials in the USA and is seen to have better results than case finding by doctors or patient surveys [12, 13]. These software models rely on clinically- and cost-similar disease categories called diagnostic cost groups (DCG) [14] or adjusted clinical groups (ACG) [15] that are generated from insurance claims data.. In Germany, chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), and type 2 diabetes mellitus (DM) were among the 20 most frequent causes for hospital admission in 2008 [16]. All three conditions are stated as being ambulatory care sensitive conditions (ACSC), meaning that primary care has a dominating role in preventing hospital admissions for these conditions [17]. Hospitalisations may be avoidable by coordinated ...
Despite tremendous advances in PCI over the past decade, early periprocedural mortality remains a concern. Using data from the NDCR, we identified demographics, clinical factors, and angiographic features associated with PCI in-hospital mortality. These were summarized into a full risk model (with both pre-procedure and angiographic features) and a simplified 8-item NCDR CathPCI Risk Score, to support both robust hospital outcome comparisons and patient-level pre-procedural risk estimation, respectively. Both the full and simplified models retain their predictive accuracy in important patient subsets, in separate internal validation samples, and when estimating 30-day mortality in Medicare patients.. Several risk-adjustment models have been previously developed for the prediction of mortality following PCI. However, many of these were developed using data that predates the generalized use of stents and/or contemporary adjuvant antithrombotic therapy (5-13). Other models have been developed from ...
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The Office of Management and Budget is reviewing an interim final rule from CMS on the ratification and reissuance of the methodology for the risk adjustment program, a sign the agency may be preparing to unfreeze the payments.
All topics of discussion must be based on factual information, for example: Coding rules or guidelines, changes to the model (proposed and finalized),inclusion or exclusion of diagnosis codes in the CMS-HCC or Rx-HCC model, discussion of the annual Advance notice, discussion of the annual Announcement provisions, CMS posted rules related to coding or Risk Adjustment, general questions about medical records, mentions of a specific solution that are integral to the comment (e.g., we use blank report from Ascender to determine _______) which do not constitute an endorsement of the product; Recommendations of other CMS or other tools which are available at no charge to the public (e.g, the American Academy of Family Practice has a good general physical exam template. It can be downloaded at ...
I am doing a RADV audit for patients for DOS in 2006. A high level definition of the RADV audit is Risk Adjustment data Validation, that requires us (
The COVID-19 pandemic has resulted in some patients not receiving care, impacting diagnosis coding data needed for risk adjustment.
We sought to examine the mortalities further through detailed review of the clinical record and angiograms in an effort to classify the deaths into 1 of 3 categories: 1) no complication of the procedure thought to have contributed to death; 2) complication of procedure possibly related to patients death; and 3) procedural complication materially contributing to the patients death. Charts and films were reviewed independently by 2 board-certified interventional cardiologists blinded to both the identity of the patient and the performing interventional cardiologist. Determinations of causality were made based on major neurologic, vascular, or cardiac complications occurring during the procedure or during the hospitalization after the PCI. Examples include intracerebral hemorrhage, major vascular complications requiring surgery or leading to hemodynamic instability, coronary complications including dissection and loss of vessel, or acute or subacute stent thrombosis. Of the 85 deaths, 11 (13%) ...
Data Collection Notes: (1) Census tracts and block groups are not included in these files. (2) These data files were obtained from the United States House of Representatives, who received them from the Census Bureau accompanied by the following caveats: The numbers contained herein are not official 1990 decennial Census counts. The numbers represent estimates of the population based on a statistical adjustment method applied to the official 1990 Census figures using a sample survey intended to measure overcount or undercount in the Census results. On July 15, 1991, the Secretary of Commerce decided not to adjust the official 1990 decennial Census counts (see 56 Fed. Reg. 33582, July 22, 1991). In reaching his decision, the Secretary determined that there was not sufficient evidence that the adjustment method accurately distributed the population across and within states. The numbers contained in these tapes, which had to be produced prior to the Secretarys decision, are now known to be biased. ...
Conventional methods do not control for unmeasured factors, which often remain important when addressing confounding by indication. PS and IV analysis methods can be useful under specific situations, but neither method adequately controlled confounding by indication in this study.
Federal regulators are considering changes to the Affordable Care Acts Hierarchical Condition Categories (HCC), according to a discussion paper written and released by CMS on March 31, 2016.
The Charlson Comorbidity Index (CCI) can be automatically calculated from the International Classification of Disease (ICD) code. However, the feasibility of this transformation has not been acknowledged, particularly in hospitals without a qualified ICD coding system. Here, we investigated the utility of coding-based CCI in China. A multi-center, population-based, retrospective observational study was conducted, using a dataset incorporating 2,464,395 adult subjects from 15 hospitals. CCI was calculated using both ICD-10-based and diagnosis-based method, according to the transformation rule reported previously and to the literal description from discharge diagnosis, respectively. A κ coefficient of variation was used as a measure of agreement between the above two methods for each hospital. The discriminative abilities of the two methods were compared using the receiver-of-operating characteristic curve (ROC) for prediction of in-hospital mortality. Total agreement between the ICD-based and diagnosis
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The underlying vision for pediatric quality measurement is improved care and health outcomes for children. Quality measures help realize this vision, through capturing system successes and failures in supporting child health. There are a large number of quality measures, some of which are focused on processes, some on outcomes, and some on use.1 To accurately assess successes and failures in care delivery, measure design matters. This is because measures can deeply incentivize behavior because of their use in reputational (eg, public reporting) and financial incentive (value-based purchasing) programs. In this issue of Pediatrics, Gay et al2 focus on risk-adjusted geometric mean length of stay (RA-LOS), a commonly used metric for understanding hospital use. Hospitals and payers often use this to assess efficiency and throughput, with the most familiar manifestation being the focus on discharge before noon. But increased RA-LOS can also signal issues with patient safety and increased ...
The injury scores and models discussed here are generally applied using retrospectively collected data. They are therefore suitable for case mix adjustment or risk prediction in groups of patients but are not appropriate for individual patient predictions to guide clinical management decisions. They have a host of applications including quality improvements in patient care, trauma systems and health care delivery, injury prevention initiatives, and epidemiological studies of injury. Patient-specific clinical prediction applications are more simple, requiring decision rules to categorize patients into low-risk/high-risk bins and present less sophisticated statistical demand. ...
How are we to evaluate outcomes for the care that we provide, and how are we to benchmark ourselves compared with colleagues at other institutions? It is critical that we do this to improve our own performance, and it is also being demanded of us by other stakeholders in society. Indeed, regular public reporting of outcomes is now effectively mandated of providers in many medical disciplines, and standards for statistical adjustment have been developed.1 As a result, performance reports based on data from both administrative and clinical databases are commonplace, with a few elite databases serving as de facto sources of truth for medical performance in the United States. However, important questions must be asked about the registries being used to set performance standards and inform medical regulatory policies.. Within cardiology, one of the most commonly reported metrics is mortality after revascularization, either in-hospital or some time thereafter, often 30 days. Such reporting may be at ...
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This post was coauthored by Michael Geruso, Timothy Layton, and Daniel Prinz. Michael Geruso is an Assistant Professor of Economics at the University of Texas
It has long been a belief of mine that the industry in which a company operates has a huge impact on its performance, and that most industries simply are not worthwhile for long-term investment consideration. To further this discussion, I took the detailed industry data found in Professor Ken Frenchs data library, and analyzed the performance of each over the fifty-year period ending in November of 2019.. Before jumping into the analysis, I should offer a few caveats regarding the data. First, the data for some of the industries is skewed by Professor Frenchs somewhat unique grouping decisions. For example, to create the transportation industry portfolio, historically poor performers like airlines and freight shipping were amalgamated with a historically strong performer, railroads. Were groupings like these to be broken out and analyzed separately, the results could change materially. Secondly, I have decided to focus my analysis on risk-adjusted returns as I believe that this is a better ...
What I mean is that all the p-value adjustment methods require some of the p-values to be very small in order to survive multiple testing adjustment when the number of gene sets is large, and getting very small p-values requires a prohibitively number of permutations.. For example, suppose you are testing the MSigDb C2 collection with about 5000 gene sets. You need the smallest p-values to be about 0.05/5000 or smaller in order to get an FDR below 0.05, and this requires 10^5 permutations. To get a worthwhile number of DE sets, the number of permutations needs to be much larger again, which is prohibitively slow. Even then, all the gene sets with the smallest p-value will be equally ranked because permutation cant resolve small p-values. Its all quite unsatisfying.. The same considerations would apply to SAM or to any permutation method, which is why SAM instead uses a FDR estimate based on the global permutation distribution of the test statistic. SAM is often applied to very small samples ...
pgamma(sum(-log(pvals.less)), shape = k, rate = 1, lower.tail = FALSE) @ \newpage. \section*{Microarray studies}. The usual application of meta-analysis is to analyze a single outcome, or finding, using published data where typically only summary statistics are available. With microarray experiments, we are often in the more fortuitous situation of having the complete set of primary data available, not just the summary statistics. By phrasing the synthesis in terms of standard statistical models, many of the recently developed $p$-value adjustment methods for multiple comparisons can be applied directly.. \subsection*{The experimental data}. We will use three data sets as examples. One is a study of breast cancer reported by \cite{West2001} in which 46 patients were assayed and two phenotypic conditions were made public, the estrogen receptor (ER) status and the lymph node (LN) status. We will refer to this as the Nevins data in the remainder of the text. The samples were arrayed on Affymetrix ...
Ive plotted up some USHCN station information for the 18 sites closest to Susanville (why Susanville - its one of the Anthony Watts- Russ Steele sites that they happened to post on lately.) Ive been reading Karl and Williams 1987 which sort of describes the USHCN Station History Adjustment method. Ill talk about Karl and…
Pulsimeter and adjustment method of pulsimeter | Analog and digital signal processing for a wearable ECG system | Method and apparatus for acquiring a magnetic resonance imaging dataset | Biological information monitoring apparatus | Chair pad system and associated, computer medium and computer-implemented methods for monitoring and improving... |
The results indicate that worthwhile correlations between case-mix adjusted SMRs and rates of preventable mortality are not attainable unless rates of preventable mortality are either (a) much higher than current estimates suggest, or (b) implausibly variable between different hospitals. It can be argued that specificity is not crucial to the performance of SMRs, since they are used as a screen for hospitals requiring further investigation, not as a diagnostic trigger for sanction. However, there is always a trade-off between sensitivity and specificity even for screening tests. In the case of SMRs, high false positives waste resources, stigmatise hospitals, and lead to gaming;29 ,30 while false negatives provide false reassurance, thereby deflecting attention away from quality issues across the whole healthcare system.31 Until risk adjustment can explain much larger proportions of the variance in mortality it is unsafe to use high SMRs to identify poor quality of care in any particular ...
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The list below describes how CAT Plus treats each condition category. Some conditions are treated as being current whether they are recorded as active or inactive (i.e. they are not recoverable) and others only if they are recorded as active.. This list will be reviewed by our clinical advisors and occasionally can be changed to include new conditions and to revise the criteria.. Please also refer to the mapping guides for your clinical system on the details of what CAT4 maps to the conditions listed in this table.. ...
TY - JOUR. T1 - Impact of race/ethnicity and socioeconomic status on risk-adjusted hospital readmission rates following hip and knee arthroplasty. AU - Martsolf, Grant R.. AU - Barrett, Marguerite L.. AU - Weiss, Audrey J.. AU - Kandrack, Ryan. AU - Washington, Raynard. AU - Steiner, Claudia A.. AU - Mehrotra, Ateev. AU - Hoo, Nelson F.Soo. AU - Coffey, Rosanna. PY - 2016/1/1. Y1 - 2016/1/1. N2 - Background: Readmission rates following total hip arthroplasty (THA) and total knee arthroplasty (TKA) are increasingly used to measure hospital performance. Readmission rates that are not adjusted for race/ethnicity and socioeconomic status, patient risk factors beyond a hospitals control, may not accurately reflect a hospitals performance. In this study, we examined the extent to which risk-adjusting for race/ethnicity and socioeconomic status affected hospital performance in terms of readmission rates following THA and TKA. Methods: We calculated 2 sets of risk-adjusted readmission rates by (1) ...
If your home has been damaged due to a severe storm or your business has experienced a fire, its important that you get professional assistance for your insurance claims. At Hope Public Adjusters, we are able to help homeowners and business owners with their insurance claims so they can get the maximum settlement. We are able to serve all of Indiana and provide you with a public insurance adjuster in TN that will fight for you and advocate for you on your behalf. Although insurance companies usually have their own adjusters, they are going to do whats best for the insurance company and not for you; the public adjusters at Hope Public Adjusters work for you and only you, so we will work hard to ensure you get a fair settlement.. The public insurance adjuster that works on your claim is able to review your insurance coverage policy and determine if your insurance company was within their right to deny your claim or give you less than your initial claim. From there, we will be able to inspect ...
If your home has been damaged due to a severe storm or your business has experienced a fire, its important that you get professional assistance for your insurance claims. At Hope Public Adjusters, we are able to help homeowners and business owners with their insurance claims so they can get the maximum settlement. We are able to serve all of Indiana and provide you with a public insurance adjuster in TN that will fight for you and advocate for you on your behalf. Although insurance companies usually have their own adjusters, they are going to do whats best for the insurance company and not for you; the public adjusters at Hope Public Adjusters work for you and only you, so we will work hard to ensure you get a fair settlement.. The public insurance adjuster that works on your claim is able to review your insurance coverage policy and determine if your insurance company was within their right to deny your claim or give you less than your initial claim. From there, we will be able to inspect ...
20. A camera module, comprising: a lens unit configured to take in light from an object and focus an object image; an image sensor configured to capture the object image; and an image processing apparatus configured to perform a process of an image signal acquired by capturing in the image sensor, wherein the image processing apparatus includes: a white balance adjustment unit configured to perform a white balance adjustment by multiplication of a white balance gain, on an image signal; a first color judgment gate generation unit configured to generate a first color judgment gate that defines an entire range of a color temperature subject to the white balance adjustment; a second color judgment gate generation unit configured to generate a second color judgment gate that defines the range of the color temperature subject to the white balance adjustment for each light source identified according to the white balance gain; and a color judgment gate switch unit configured to switch the first color ...
Objective. - To compare performance of different health status measures for risk-adjusting capitation rates. Design. - Cross-sectional study. Health status measures derived from 1 year were used to predict resources for that year and the next. Setting. - Group-network health maintenance organization in Minnesota. Participants. - Sample of 18-to...
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Performance ranking is a key factor for investors to make investment decisions such as redemption. Numerous studies have shown that in order to improve and secure the year-end relative performance ranking, mid-year performance rankings have prompted fund managers ranked at different mid-year levels to adjust the risk levels of their portfolios to varying degrees in the second half of the year. This study is of great significance to improve the incentive mechanism of fund companies, investor investment activities and the performance of regulatory responsibilities by state institutions. First of all, this paper makes a full sample study of the risk adjustment behavior of fund manager based on the funds first-half performance by using the combination table analysis method and regression analysis method, and further studies the relationship between market state and fund managers risk adjustment behavior. Result: Fund managers (losers) with lower mid-year performance increase portfolio risk
Not only every patient is different, but also every drug. Drug dosage must be individualised, and adjusted to the patients organ func- tion (e.g. age, kidney) and severity of disease (e.g. intensive care, outpa- tient office). Within an European project, we are on the way to built up a drug information and dosage adjustment system. The essential compo- nents are available: the pharmacokinetic /-dynamic database NEPharm, calculation algorithms, a consensus on general pharmacokinetic concept, on dose adjustment rules, and on standard nomenclature (ATC code). A graphical user interface must be designed. The required components must be made interoperable, namely patient record, drug dictionary, phar- macokinetic /-dynamic database, calculation algorithms, graphical user interface. The dosage proposals made by the system must be clinically certified, and be compared to standard practice in an external environ- ment to evaluate clinical applicability and reliability. Special versions of the system ...
hearing aid adjustment systems market is the new research study published by Acquire Market Research and added to its vast data library of whitepapers & Market Research Reports. This report gives insight into key players, market size by types, applications and major regions.
This master thesis attempts to estimate the short-run and long-run price and income elasticities of crude oil demand in ten IEA member-countries for the time period 1980-2009. Specifically, the price and income elasticities for Sweden, Denmark, Spain, Portugal, Turkey, Finland, Italy, Germany, USA, and Japan are estimated. Crude oil consumption is a function of four explanatory variables: real oil prices, real GDP per capita, oil consumption lagged one year and a time trend representing technological improvements. The econometric model that is used is a multiple regression model derived from an adaption of Nerloves partial adjustment model. Empirical results reveal that elasticities (both price and income) are lower in the short-run and hence more inelastic, indicating that countries need time to respond to changes in price or income. Econometric estimations illustrate that oil consumption is highly price inelastic both in short-run and long-run. Income elasticities are more elastic than price ...
Downloadable (with restrictions)! This paper uses a multiple regression model derived from an adaptation of Nerloves partial adjustment model to estimate both the short-run and long-run elasticities of demand for crude oil in 23 countries. The estimates so obtained confirm that the demand for crude oil internationally is highly insensitive to changes in price. Copyright 2003 Organization of the Petroleum Exporting Countries.
An important subset of the literature on agglomeration externalities hypothesizes that intrasectoral and intersectoral relations are endogenously determined in models of local and regional economic growth. Remarkably, structural adjustment models describing the spatio-temporal dynamics of population and employment levels or growth traditionally do not include intersectoral economic dynamics. This paper argues and shows that ... read more allowing for economic linkages across sectors in these models adds considerable value, especially in forecasting. An econometric model of population-employment dynamics, in which sectoral variations in economic development are explicitly taken into account, is applied to a large urban planning policy proposal in the Netherlands. The empirical analyses suggest that population dynamics are largely exogenous, population changes drive employment in particular in the industry and retail sectors, and employment in all sectors depends strongly on intersectoral ...
Throughout the Holocene, appreciable changes in bathymetry are hypothesized to have resulted in large changes to tidal datums in coastal and estuarine areas. An understanding of tidal change is an important contribution to the knowledge of relative historical sea-level change and future coastal planning. To test this hypothesis, the Advanced Circulation (ADCIRC) model was used, with representative bathymetric grids based on glacial isostatic adjustment models and semi-empirical sea level rise predictions, in order to model the time-varying tidal behavior of the Delaware Bay. Model runs were conducted at various time slices between 10,000 years before present and 300 years into the future on high resolution grids that allowed for inundation moving forward in time. Open boundary tidal forcing was held constant in time to highlight the effect of the changing regional bathymetry. With each change in sea level, the shape of the Delaware Bay was considerably altered, leading to changes in the tides. ...
The largest abrupt climatic reversal of the Holocene interglacial, the cooling event 8.6-8.2 thousand years ago (ka), was probably caused by catastrophic release of glacial Lake Agassiz-Ojibway, which slowed Atlantic meridional overturning circulation (AMOC) and cooled global climate. Geophysical surveys and sediment cores from Chesapeake Bay reveal the pattern of sea level rise during this event. Sea level rose ~14 m between 9.5 to 7.5 ka, a pattern consistent with coral records and the ICE-5G glacio-isostatic adjustment model. There were two distinct periods at ~8.9-8.8 and ~8.2-7.6 ka when Chesapeake marshes were drown as sea level rose rapidly at least ~12 mm yr−1. The latter event occurred after the 8.6-8.2 ka cooling event, coincided with extreme warming and vigorous AMOC centered on 7.9 ka, and may have been due to Antarctic Ice Sheet decay ...
Steven G. Wraith and Donna M. Young prevailed on a summary judgment motion in Insured v. Engineering Firm in King County Superior Court. The court dismissed all claims alleging that an engineering firm was acting as an unlicensed insurance adjuster. The plaintiffs, insureds under a homeowners policy, filed a bad faith claim against their property insurer because it had not paid them for all the home renovation costs after a water loss claim. The insurance adjuster retained an engineering firm to review the invoices submitted by the insureds contractor, billed on a time and materials basis, to determine which charges were related to the water loss. The engineering firm separated the charges into categories of related and unsubstantiated. The insureds claimed that the engineering firm was acting as an unlicensed adjuster when it performed this consulting work. Based on the definition in RCW 48.17.010, the insureds argued that adjuster includes anyone who provided an opinion on an insurance ...
Adjusters may decide to interview the parties in a car accident or key witnesses, such as passengers or passersby. Adjusters may decide to do this if the damages claimed or personal injuries are significant, the claim is too large or seems unreasonable, or if the insurer wants to pay the lowest claim figure possible. Adjusters ask about how the accident happened, damages, and conduct of the parties. The interview conversation may be used later in claims or legal processes, often against the claimant. For this reason, some claimants prefer to hire legal counsel prior to submitting to any insurance interview. Insured parties must be careful not to admit liability or fault in any phone conversations, visits, or interviews with adjusters or other representatives of insurers.. ...
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Refinements to the CMS-HCC Model For Risk Adjustment of Medicare Capitation Payments. Presented by: John Kautter, Ph.D. Gregory Pope, M.S. Eric Olmsted, Ph.D. RTI International. Contact: John Kautter, PhD, [email protected] RTI International is a trade name of Research Triangle Institute. Slideshow 372101 by desma
Insurance companies hire adjusters to place a dollar value on each case. Because insurance adjusters handle many cases every day, they tend to give mental labels to injuries and use these to decide how big or small their settlement offer will be. But if an adjuster gives a serious injury a
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Managing complex patients requires greater clinician effort, increased health care resources, and substantial family and community support, says Grant, who recently joined the division of Research at Kaiser Permanente Northern California. In order to redesign our health care systems to more effectively care for complex patients, we need a better handle on exactly who they are. By asking primary care physicians about their experiences with their own patients in a systematic and quantitative way, we were able to bring out the importance of social and behavioral factors, in addition to specific medical problems. This work may help guide efforts to redesign health care systems so that we can deliver high quality, cost-effective care tailored to individual patient needs ...
Southern California Hospital at Culver City received five-star ratings for Treatment of Heart Attack and Heart Failure for the fifth year in a row by Healthgrades (2015-2019). Heart failure occurs when your heart is damaged and too weak to pump enough oxygen-rich blood to the body.. We are proud to be clinically recognized for our treatment of heart attack and heart failure, said hospital CEO Michael Klepin. Our community can take comfort in the fact that nationally recognized cardiac care is available close to home.. In addition, the Culver hospital also was a Healthgrades five-star recipient for Pacemaker Procedures for two years in a row (2018-2019). To support the clinical achievements, the hospital is among the top 5% in the nation for Patient Safety Excellence (2018-2019).. Healthgrades star ratings are an evaluation of the hospitals actual performance as compared to the predicted performance for that hospital based on a specific risk-adjustment model applied to that hospital. ...
Pancreatitis is an inflammation of the pancreas. The pancreas can become inflamed if the digestive juices it produces, called enzymes, attack the gland itself. Pancreatitis can be an acute or a chronic condition.. Healthgrades is the leading online resource for helping consumers make informed healthcare choices regarding doctors and facilities. Each year, Healthgrades evaluates approximately 4,500 hospitals and healthcare systems on their performances on the most common inpatient procedures and conditions. Star ratings are an evaluation of the hospitals actual performance as compared to the predicted performance for that hospital based on a specific risk-adjustment model applied to that hospital.. LEARN MORE ABOUT OUR HEALTHGRADES RATINGS ...
The development of a viable self-calibration approach for use with non-metric cameras was investigated. Both computer generated and actual test camera data were generated to determine the effectiveness of the math model and computer program. A twenty-seven parameter bundle adjustment routine was proposed because of its versatility and compatible use in an existing aerotriangulation package. For the camera and test configuration considered, the focal length was recovered to within two percent, and the principal point location was recovered to wi thin O. 3 to twelve percent. When the computer generated data was used, the focal length and principal point offset were recovered to within 0.2 percent.. Modeling and software has been made available for a future comparative study between the self-calibration and Direct Linear Transformation adjustment parameters. The self-calibration modeling and former Direct Linear Transformation modeling software is a promising tool for mensuration tests and ...
Everyone is aware that salespeople will employ different tactics to seal the deal. In this case, it is important to know how insurance adjusters work, to avoid falling victim to bad individuals. Unfortunately, many consumers are unable to evaluate insurance adjusters with the proper level of scrutiny. It is important to know more about these […]
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Now that we have finished the above manuscript, we will focus on how to control for the affect of co-morbid conditions when quantifying the risk of death from AF and other heart diseases. This knowledge will help clinicians to understand the interaction between AF and comorbidities, and to target specific comorbid conditions to reduce risk of death. We will focus on two popular comorbidity measurements that use administrative databases-the Charlson-Deyo scheme1 and the Elixhauser scheme.2 Neither scheme was developed and tested in populations with heart disease. Thus, their applicability to the AF population is unknown. Purposes of the study are: (1) to evaluate predictive accuracy of two existing comorbidity schemes to each other and to a disease-specific co-morbidity index, CHADS2, that has been used to predict stroke in the AF population.3. We have made two important pieces of progress towards the AF analysis. First, we have obtained permission from the Center of Medicare and Medicaid ...
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The purpose of this white paper is to begin the consultation process around the development of the federally-certified risk adjustment methodology developed by HHS and provide context for individuals to submit comments regarding the Standards Related to Reinsurance, Risk Corridors and Risk Adjustment Notice of Proposed Rulemaking (NPRM) (45 CFR Part 153), issued July 15, 2011. ...
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An adjuster is a person professionally trained to assess the damage. The more information you have about your possessions the faster your claim can be settled. You should already have a complete inventory of the items in your home that includes a description of the item, model and serial numbers (if applicable) and the original cost and what it would cost to replace it.. Make a list of damaged items. Take photographs of the damage and put together a set of records for each item that includes any old receipts or bills. Dont forget to list items such as clothing, sports equipment, tools, china and linens, etc.. Dont throw away damaged furniture or other items because the adjuster will want to see them.. Identify the structural damage to your home and other buildings on your premises. Make a list of everything you want to show the adjuster when they arrive. In some cases, the adjuster may recommend hiring a licensed engineer or architect to inspect the property. You should also get the electrical ...
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Eighteen pediatric quality indicators are included in the AHRQ quality measure modules; based on expert input, risk adjustment ... 2007). "Technological iatrogenesis: New risks force heightened management awareness" (PDF). Journal of Healthcare Risk ... "High risk procedures or medical specialties are responsible for most avoidable adverse events". Although some mistakes, such as ... "INFANTS AT RISK: WHEN NURSE FATIGUE JEOPARDIZES QUALITY CARE : Advances in Neonatal Care". LWW. Retrieved 2016-04-01. Williams ...
"Risk Adjustment Fraud » Constantine Cannon". Retrieved 2017-12-05. "hhs.gov". hhs.gov. 2011-05-07. Retrieved 2012-01-02. ...
"UPMC and Health Fidelity Partnership a Win-Win for Risk Adjustment" (PDF). February 2019. "Project Information - NIH RePORTER ... "Health Fidelity , NLP-Enabled Risk Adjustment Technology". Health Fidelity, Inc. Retrieved 2019-09-03. ""21st Century ... a company which implements artificial intelligence to measure clinical quality and risk for value-based healthcare. As CEO, ...
Smith, S. L., Howard, J.A., & Monroe, A.D. (2000). "Issues underlying behavior problems in at-risk adopted children." Children ... Levy-Shiff, R. (2001). Psychological adjustment of adoptees in adulthood: Family environment and adoption-related correlates. ... Levy-Shiff, R. (2001). "Psychological adjustment of adoptees in adulthood: Family environment and adoption-related correlates ... Brodzinsky, D. M. (1987). "Adjustment to adoption: A psychosocial perspective."Clinical Psychology Review, (7) 25- 47. ...
Estimated per-act risk for acquisition of HIV by exposure route [2][3][4] Exposure Route [5] Estimated infections per 10,000 ... May have significant interactions with other drugs; dosage adjustments would be required ... Means the risk of getting HIV for a single sexual act. *↑ Smith DK, Grohskopf LA, Black RJ; et al. (January 2005). " ... Bell DM (1997). "Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview". Am. J. Med. ...
D'Agostino RB, Wolf PA, Belanger AJ, Kannel WB (January 1994). "Stroke risk profile: adjustment for antihypertensive medication ... Major risk factors for cerebral infarction are generally the same as for atherosclerosis. These include high blood pressure, ... It is also possible to calculate the risk of stroke in the next decade based on information gathered through the Framingham ... Hankey GJ (August 2006). "Potential new risk factors for ischemic stroke: what is their potential?". Stroke. 37 (8): 2181-8. ...
"Index Futures and the Adjustment of Risk." The American Banker. October 10, 1983. Richard L. Sandor. "When You're Trading ... Risk Books. September 1999. Richard L. Sandor and Michael J. Walsh. "Some Observations on the Evolution of the International ... Securitized Risk Strategic Opportunities for Insurers and Investors. The Glenlake Publishing Company Ltd. 1998. p. xi Taylor, ... Richard L. Sandor and Howard Sosin, " The Determinants of Mortgage Risk Premiums: A Case Study of the Portfolio of a Savings ...
... the adjustment (increment) to a derivative price due to the institution's own default risk. If the default risk of both ... Capital Valuation Adjustment and Funding Valuation Adjustment. Risk Magazine, May 2016. See Black-Scholes equation § Derivation ... While the CVA reflects the market value of counterparty credit risk, additional Valuation Adjustments for debit, funding cost, ... John Hull (May 3, 2016). "Valuation Adjustments 1". fincad.com. XVA and Collateral: pricing and managing new liquidity risks. ...
Bera, Anil K.; Kannan, S. (1986). "An Adjustment Procedure for Predicting Systematic Risk". Journal of Applied Econometrics. 1 ... Bera, Anil K.; Billas, Y.; Dogan, O.; Taspinar, S.; & Yoon, M. (2020). "Adjustment of Rao's Score Test for Distributional and ... Bera, Anil K.; Park, H.Y. (1987). "Interest Rate Volatility, Basis Risk and Heteroscedasticity in Hedging Mortgages". Journal ... Bera, Anil K. and Machado, J. (1992). 'Bayesian Estimation of Systematic Risk Using Hierarchical and Nonnormal Priors'. ...
How Does Risk Selection Respond to Risk Adjustment? New Evidence from the Medicare Advantage Program (PDF). American Economic ... 在《PPACA》頒布之前(2010年頒布,2014年正式實施),美國約有34個州提供擔保發行風險庫(guaranteed-issuance risk pools),讓那些無法獲得私人醫療保險的個人,可購買由州贊助的醫療保險計劃,但是通常費用較高,而且自負 ... The Next Generation High-Risk Pool. The Actuary Magazine. 2017-07-
Risks[edit]. Vendors of cock rings and medical sources indicate that cock rings are not to be worn for more than about 30 ... Another variation is an inflatable cock ring for added control of adjustment. ...
Kelly, J. B.; Emery, R. E. (2003). "Children's Adjustment Following Divorce: Risk and Resilience Perspectives". Family ... 3 Risk, Disorder, and Adaptation. Hoboken, NJ: Wiley and Sons. Garmezy, N. (1974, August) The study of children at risk: New ... However, this is not a justification to expose any child to risk. Children do better when not exposed to high levels of risk or ... "Emotional Adjustment of Moving for Young Kids". Moveboxer.com. Wang, Haertel, & Walberg, M.C., G.D., & H.J (Ed.). (1994). ...
"How does Risk Selection Respond to Risk Adjustment? Evidence form the Medicare Advantage Program." American Economic Review 104 ... The study finds that parole boards efficiently set prison time based on a prisoner's recidivism risk, thus reducing recidivism ...
Perspectives on Adjustment, Risk, and Disorder. Cambridge University Press. p. 123. ISBN 978-0-521-47715-4. Gottfredson, Linda ...
Risk aversion is a kind of trading behavior exhibited by the foreign exchange market when a potentially adverse event happens ... Johnson, G. G. (1985). Formulation of Exchange Rate Policies in Adjustment Programs. ISBN 0939934507. Retrieved 15 November ... In fact, a forex hedger can only hedge such risks with NDFs, as currencies such as the Argentinian peso cannot be traded on ... One way to deal with the foreign exchange risk is to engage in a forward transaction. In this transaction, money does not ...
Brown, Jason; Duggan, Mark; Kuziemko, Ilyana; Woolston, William (2014). "How Does Risk Selection Respond to Risk Adjustment? ... They will be less likely to cover higher-risk populations, which would cause an imbalance in the risk pool for other small ... the risk of disability is greater than the risk of premature death, and the resulting reduction in lifetime earnings can be ... Since people who lack health insurance are unable to obtain timely medical care, they have a 40% higher risk of death in any ...
Brown, Jason; Duggan, Mark; Kuziemko, Ilyana; Woolston, William (2014). "How Does Risk Selection Respond to Risk Adjustment? ... The Part C risk adjusted payments to Medicare Advantage plans are designed to limit this churn between types of Medicare ( ... The fee is then adjusted up or down based on the beneficiary's personal health condition; the intent of this adjustment is that ... The theory is that the risk-based formula will not affect spending, but in practice it almost always increases cost per ...
... psychological adjustment of individuals at risk for hereditary disease; and the design and evaluation of interventions in the ... Her work on risk of depression was published in Lab+Life Scientist magazine. The website for family depression and its ... "Your risk of depression may be lower than you think". labonline.com.au. Retrieved 2019-07-26. "Family depression website". Good ... at increased risk for ovarian cancer Participant in Psychosocial predictors of developing breast cancer in women from high risk ...
TQIP measures multiple variables in its risk-adjustment models. These variables include factors such as age, race, gender, ... Deliverables comprise risk adjusted hospital comparisons in the form of one annual benchmark report as well as two separate ... Its aim is to provide risk-adjusted data for the purpose of reducing variability in adult trauma outcomes and offering best ... The aggregate group had a relative risk-mortality of 3.3, while the single-system trauma cohort had a mortality 5.9 times ...
Finkelstein, Amy; Gentzkow, Matthew; Hull, Peter; Williams, Heidi (2017). "Adjusting Risk Adjustment - Accounting for Variation ...
... not a case of adjustment. This has been much-debated in Wisner et al.'s At Risk (2004). ... Risk Assessment of Environmental Hazards. SCOPE Report 8. John Wiley.. *Burton I and Kates R.W. 1978. The Environment as Hazard ... Burton, I, R W. Kates, J R. Mather and R E. Snead, The Shores of Megalopolis: Coastal Occupance and Human Adjustment to Flood ... the assessment of risk, and the impacts of climate on society. Since retiring from Brown University he continued to work on: * ...
... fenofibrate interacts with coumadin anticoagulants to increase the risk of bleeding. Dosage adjustment of vitamin K antagonist ... It is less preferred to statin medications as it does not appear to reduce the risk of heart disease or death. Its use is ... Steiner G (2009). "How can we improve the management of vascular risk in type 2 diabetes: insights from FIELD". Cardiovasc ... Fenofibrate appears to decrease the risk of cardiovascular disease and possibly diabetic retinopathy in those with diabetes ...
... humans may intervene to help adjustment. Without mitigation, adaptation alone cannot avert the risk of "severe, widespread and ... Adaptation can help decrease climate risk via the three risk factors: hazards, vulnerability and exposure. Climate hazards may ... Transferring risk to the public purse does not reduce overall risk Governments can spread the cost of losses across time rather ... As of 2020[update], the GCF has failed to reach its expected target, and risks a shrinkage in its funding after the US withdrew ...
Risk adjustment involves transferring funds from plans with lower-risk enrollees to plans with higher-risk enrollees. It was ... Of the three risk management programs, only risk adjustment was permanent. Plans with low actuarial risk compensate plans with ... Risk Adjustment, Reinsurance, and Risk Corridors". The Henry J. Kaiser Family Foundation. Retrieved November 28, 2019.CS1 maint ... The risk-corridor program was a temporary risk management device. It was intended to encourage reluctant insurers into ACA ...
The Lown Institute is currently conducting research on risk adjustment methods for evaluating patient outcomes. ...
Field, N. P., & Filanosky, C. (2010). Continuing bonds, risk factors for complicated grief, and adjustment to bereavement. ... to determine when continuing bonds experiences serve adjustment to bereavement and when they may be detrimental. The main ...
... "risk 1"), are more vulnerable to the adverse effects of negative experiences (i.e., "stress" or "risk 2"), whereas others are ... El-Sheikh, M., Harger, J., & Whitson, S. M. (2001). Exposure to interparental conflict and children's adjustment and physical ... Figure 1. The diathesis-stress/dual-risk model. Developmental outcome as it relates to environmental quality. A "vulnerable" ... While diathesis-stress/dual-risk arises when the most vulnerable are disproportionately affected in an adverse manner by a ...
Lithium: Renal Cl of lithium may be reduced and plasma levels may be elevated, which may increase the risk of lithium toxicity. ... Phenobarbital: May decrease fenoprofen t ½ . Dosage adjustments of fenoprofen may be required if phenobarbital is added or ... SSRIs (e.g. fluoxetine, citalopram): The risk of GI effects may be increased. ...
On the outside of the reel there are two levels of knobs these are the spool release and the drag adjustment. Fly reel drag ... There are higher risks of getting backlashes during the cast without proper techniques. One must know about spool tension ... Rear drags, have an adjustment screw on the back of the reel along with a separate lever to activate its use. It automatically ... Although adequate for smaller fish, these did not possess a wide adjustment range or the power to slow larger fish. At one time ...
Reshaping of the cranial vault most commonly means excision of the bones to allow shape adjustment.[42] Replacement of cranial ... Most surgeons will not intervene until after the age of six months due to the heightened risk which blood loss poses before ... The main risks of prolonged elevated intracranial pressure may include cognitive impairment and impaired vision through ... Medical history should in any case include questions about risk factors during pregnancy, the familial rate and the presence of ...
Small, temporary tuning adjustments can also be made by stretching a string with the hand. A string may be flattened by pulling ... Like any other unwarranted tension, it limits freedom of motion, and increases the risk of discomfort, while decreasing sound ... the amount of adjustment needed may be greatly reduced by training the fingers to fall properly in the first place. ...
JEL: G32 - Financing Policy; Financial Risk and Risk Management; Capital and Ownership Structure. JEL: G33 - Bankruptcy; ... JEL: F32 - Current Account Adjustment; Short-Term Capital Movements. JEL: F33 - International Monetary Arrangements and ...
Intense states of distress and unease increase the risk of suicide, as well as being unpleasant in themselves. Relieving ... Adjustment disorder with depressed mood. *Anxiety disorders such as post-traumatic stress disorder ...
Causes and Risk Factors[edit]. The cause of PNES has not yet been established. One hypothesis is that they are a learned ... The risk factors for FND can include trauma, illness exposure, symptom monitoring, and abnormal beliefs and expectations about ... Adjustment. *Adjustment disorder with depressed mood. Anxiety. Phobia. *Agoraphobia. *Social anxiety. *Social phobia * ...
"Monday Finals: No Adjustments For 'Chuck' Or Any Other Original Episode". TV by the Numbers. Retrieved May 3, 2011 ... a rage saying that poisoning him just to acquire his position as President and allowing Sophia to carry out her plan only risks ... "Monday Final Ratings: 'Harry's Law' Adjusted Up; No Adjustment For 'Chuck,' 'The Event' Or Any Other New Show". TV by the ... "Monday Final Ratings: "The Chicago Code" Adjusted Down; "Two and a Half Men" Repeat Adjusted Up; No Adjustment for 'The Event' ...
Vertebral subluxation, spinal adjustment, innate intelligence. Risks. Vertebral artery dissection (stroke), compression ... Risk-benefit. A 2012 systematic review concluded that no accurate assessment of risk-benefit exists for cervical manipulation.[ ... Spinal manipulation, which chiropractors call "spinal adjustment" or "chiropractic adjustment", is the most common treatment ... Committee to Assess Health Risks from Exposure to Low Levels of Ionizing Radiation, Board on Radiation Effects Research, U.S. ...
Reclining wheelchairs are preferred in some cases for some medical purposes, such as reducing the risk of pressure sores, ... reasonable adjustments' to ensure that disabled people are able to access their services and are not excluded. These may range ... the parts of the body that are the most at risk for tissue breakdown include the ischial tuberosities, coccyx, sacrum and ... designed both to support the user in the sitting position and to redistribute pressure from areas of the body that are at risk ...
2006). "Low-carbohydrate-diet score and the risk of coronary heart disease in women". N. Engl. J. Med. 355 (19): 1991-2002. doi ... with multivariate adjustment) between animal fat intake and coronary heart disease (table 4). A long term study that monitored ... Lengthy fasting can also be dangerous due to the risk of malnutrition and should be carried out only under medical supervision ... The American Diabetes Association recommended a low carbohydrate diet to reduce weight for those with or at risk of Type 2 ...
The conditions do increase the anesthetic risk and the rate of post-operative complications. Surgeons may require overweight ... "Psychosocial Adjustment to Sex Reassignment Surgery: A Qualitative Examination and Personal Experiences of Six Transsexual ... Hence, transgender people should be well informed of these risks before choosing to undergo SRS.[5] ...
Norman TR, Burrows GD (January 1995). "A risk-benefit assessment of moclobemide in the treatment of depressive disorders". Drug ... possibly other tricyclic antidepressants increase when used in combination with moclobemide and may require dosage adjustments ... but had a significantly lower risk of causing a manic switch.[34] This is in line with recent findings that MAOIs as a class ... antidepressants decrease the risk of suicide.[74] Moclobemide is believed to have only small proconvulsant effects;[75] however ...
"Music Therapy with High Risk Adolescents (PDF)" (PDF). American Music Therapy Association, Michigan State University Chapter. ... one could conclude that elements of music therapy could also be effective in the treatment of depression and other adjustment ... It's the added complexity to cultural empathy that comes from adding music that provides both the greater risk and potential to ... They are subject to numerous health risks, such as abnormal breathing patterns, decreased body fat and muscle tissue, as well ...
Those with worsening sight and the prognosis of eventual blindness are at comparatively high risk of suicide and thus may be in ... Therefore, early intervention is imperative for enabling successful psychological adjustment.[22]. Associated problemsEdit. ... the best way to reduce the risk of developing cataracts is to avoid smoking and extensive exposure to sun light (i.e. UV-B rays ... with the lowest risk of suicide and the highest level of social integration. ...
Food Safety Risk Management in Different Egg Production Systems. *^ a b c d Kinde, H. et al. 1996. "Salmonella enteritidis, ... study also estimated that almost the entire California egg industry would relocate to other states during the 5-year adjustment ... The Truth About Proposition 2: Putting Our Food Safety & Public Health At Risk[permanent dead link] - an anti-proposition ... "Descriptive Study of California Egg Layer Premises and Analysis of Risk Factors for Salmonella enterica serotype enteritidis as ...
Secretary of Defense and Chairman of the Joint Chiefs of Staff jointly certify that ending this arrangement will not pose risks ... Office of Economic Adjustment. *Defense Acquisition University. *Defense Acquisition Board. Under Secretary of Defense for ...
Risk aversion may stimulate activity that in well-functioning markets smooths out risk and communicates information about risk ... Post-Keynesian economics also concentrates on macroeconomic rigidities and adjustment processes. Research on micro foundations ... Uncertainty in economics is an unknown prospect of gain or loss, whether quantifiable as risk or not. Without it, household ... Related problems in insurance are adverse selection, such that those at most risk are most likely to insure (say reckless ...
They also claim that structural adjustment programs led to the privatization and liberalization of many African political and ... and reduced the risk of conflict between colonial powers.[21] Bismarck used private companies to set up small colonial ... The sleeping sickness epidemic in Africa was arrested due to mobile teams systematically screening millions of people at risk.[ ...
Several metabolic adjustments occur during fasting, and some diagnostic tests are used to determine a fasting state. For ... Fasting is often practiced prior to surgery or other procedures that require general anesthetics because of the risk of ...
april 2006). «Risk Factors for Postpartum Depression: A Retrospective Investigation at 4-Weeks Postnatal and a Review of the ... O'Hara, M.W. Depression and marital adjustment during pregnancy and after delivery. American Journal of Family Therapy 13:49-55 ... O'Hara, M.W., and Swain A.M. Rates and risk of postpartum depression - A meta-analysis. International Review of Psychiatry 8:37 ... 40] ^ Ross, Lori E. Perinatal Mental Health in Lesbian Mothers: A Review of Potential Risk and Protective Factors. Kvinner & ...
The first week of training is commonly referred to as "Hell Week," due to the intense period of adjustment required on the part ... One has to be a team player or risk ostracism. The military does things quite deliberately to intensify the power of group ... Milgrom, C.; Finestone, A.; Shlamkovitch, N.; Rand, N.; Lev, B.; Simkin, A.; Wiener, M. (January 1994). "Youth is a risk factor ... Blacker, Sam D.; Wilkinson, David M.; Bilzon, James L. J.; Rayson, Mark P. (March 2008). "Risk factors for training injuries ...
... to minimize the risk of sampling error. It shows the Liberal incumbent with a 15% lead over the PC leader, as shown in table 1 ... except for a minor boundary adjustment, to the ones that existed on October 2, 2003, and 96 southern electoral districts that ...
Security operations reduces risk to operating Marine forces from unknown avenues that may conflict in any tactical situation; ... The UAV provides high quality video imagery for artillery or naval gunfire adjustment, battle damage assessment, and ...
R Dennis Shelby; Kathleen Dolan (2014). Lesbian Women and Sexual Health: The Social Construction of Risk and Susceptibility. ... They found that children's mental health, happiness, and overall adjustment is similar to children of divorced women who are ... The risk factors for developing ovarian cancer rates are higher in lesbians than heterosexual women, perhaps because many ... Factors that add to risk of heart disease include obesity and smoking, both of which are more prevalent in lesbians. Studies ...
Another adjustment would be to use a motor vehicle that is fuel-efficient as well as reducing reliance on motor vehicles. Motor ... Risks of GHG footprints are evaluated based on the interaction of projected damages in an earth system climate change effected ... There are a lot of key risks that span over sectors and regions. This includes severe ill-health and disrupted livelihoods, ... There is also a risk of loss of biodiversity, ecosystem goods, functions, and services.[12] ...
"Risks - Pacemaker - Mayo Clinic". www.mayoclinic.org. Retrieved 2016-12-01.. *^ a b eMedicine , Pacemaker-Mediated Tachycardia ... From this the basic ventricular "on demand" pacing mode is VVI or with automatic rate adjustment for exercise VVIR - this mode ... These devices are often used in the treatment of patients at risk from sudden cardiac death. An ICD has the ability to treat ... Biventricular pacing alone is referred to as CRT-P (for pacing). For selected patients at risk of arrhythmias, CRT can be ...
Structural adjustmentEdit. The effect of structural adjustment policies on poor countries has been one of the most significant ... "New Report Examines Risks of 4 Degree Hotter World by End of Century". worldbank.org. World Bank. 18 November 2012. Retrieved ... 1987). Adjustment with a Human Face: Protecting the Vulnerable and Promoting Growth. New York, NY: Oxford University Press USA ... Structural adjustment policies were most effective in countries with an institutional framework that allowed these policies to ...
Risk factorsEdit. A marble bust of the Roman Emperor Decius from the Capitoline Museum. This portrait "conveys an impression of ... "Neuroticism's prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric ... Social risk factors for anxiety include a history of trauma (e.g., physical, sexual or emotional abuse or assault), early life ... The cause of anxiety disorders is a combination of genetic and environmental factors.[45] Risk factors include a history of ...
She risked war with Spain by supporting the "Sea Dogs", such as Walter Raleigh, John Hawkins and Sir Francis Drake, who preyed ... The urban and rural districts were based on, and incorporated the sanitary districts which created in 1875 (with adjustments, ... During the 1800s, the need for local administration greatly increased, prompting piecemeal adjustments. The sanitary districts ...
Aircraft flying polar routes near the geomagnetic poles are at particular risk.[96][97][98] ... one example is adjustment of cloud data that understates error in lower cloud data, but not in high cloud data;[108] another ... On 31 May 2013, NASA scientists reported that a possible manned mission to Mars may involve a greater radiation risk than ... "Data Point to Radiation Risk for Travelers to Mars". The New York Times. Retrieved 31 May 2013 ...
For our other new Risk Adjustment Coder Becky Priest, CPC-A, CPB, coding is actually a second career. Becky previously worked ... Capstone Performance Systems recently welcomed four new employees, including two Risk Adjustment Coders. Marina "Nina" Gonzalez ... and is working toward attaining Certified Risk Adjustment Coder (CRC) certification through the AAPC. ... A position as Finance Manager at the CentraCare PACE program in Battle Creek, Michigan, piqued her interest in the risk process ...
Risk adjustment is a modern payment model which uses both demographics and diagnoses to determine a risk score which predicts ... 1. Healthcare risk adjustment - Your top ten questions answered * 2. 1. What is healthcare risk adjustment? The most prevalent ... How many patients are covered under the risk adjustment model and is there a benefit for the patient? Under the risk adjustment ... Risk adjustment is a modern payment model which uses both demographics and diagnoses to determine a risk score which predicts ...
... as well as access to highly knowledgeable SMEs and detailed analytics to make their Risk Adjustment strategies more effective ... provides a comprehensive program that supports a health plans Risk Adjustment department. The program focuses on three primary ... today rolled out its Risk Adjustment Management Program (RAMP), designed to assist health plans participating in Medicare, ... Analytics from the program use submitted RAPS and EDPS data to show plans their risk adjusted forecast revenue based on their ...
A high level definition of the RADV audit is Risk Adjustment data Validation, that requires us ( ... A high level definition of the RADV audit is Risk Adjustment data Validation, that requires us (Medicare Advantage Insurance ... Risk Adjustment Data Validation. By st1114718 in forum Medical Coding General Discussion ...
After the adjustment. Some people experience minor side effects for a few days after chiropractic adjustment. These may include ... During the adjustment. During a typical chiropractic adjustment, your chiropractor places you in specific positions to treat ... www.mayoclinic.org/tests-procedures/chiropractic-adjustment/basics/risks/prc-20013239 ... Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only a modest ...
Risk-adjustment systems used to pay health plans in individual health insurance markets have evolved towards better "fit" of ... Simplifying and Improving the Performance of Risk Adjustment Systems Thomas G. McGuire, Anna L. Zink & Sherri Rose ... Richard van Kleef and participants at the Risk Adjustment Network Meeting in Portland, Maine, September 24-26, 2019 for helpful ... generally achieved by adding variables used for risk adjustment. Adding variables demands further plan and provider-supplied ...
Risk adjustment is a predictive model introduced by the ... Understand Risk Adjustment Basics. * By Guest Contributor * In ... Risk adjustment is a predictive model introduced by the Affordable Care Act. It gauges the risk a healthcare plan member will ... A risk adjustment value is assigned to each diagnosis code that falls into the payment model. The ICD-9-CM codes are then ... Risk adjustment takes a close look at how ICD-9-CM documentation and coding contributes to the complexity level of the ...
... get better data on their risks, and level the playing field for risk assessment and risk adjustment in the process. ... Risk adjustment requires an insurer to report on the health risk of its members, and to do that it needs good data. Plans that ... Is The Risk Adjustment Formula based more on the expected risk of the pool rather than on actual claims paid?. It seems the ... With the ACAs risk adjustment, it is possible that there will be a perpetual skew of risk towards products that are less well- ...
... Staff - Thursday, April 20th, 2017. Print , Email ... "When we look at potentially risk adjusting or re-evaluating risk for these patients, we need to do it multiple times during the ... She also recommends hospitals use precision risk-management tools to stratify risk across the bundle. Lastly, she says ... Nedza advises providers to focus in on this time period because it can help establish a sense of the risk they will need to ...
The risk adjustment program is one of the three Rs-reinsurance, risk adjustment, and risk corridors. Unlike the risk corridor ... If risk adjustment worked perfectly, plans would be indifferent about the health of their enrollees. But risk adjustment isnt ... Under any risk adjustment scheme, then, some plans will be winners and some will be losers. Thats where the new lawsuit comes ... The solution is risk adjustment. Plans with healthier-than-average enrollees are forced to pay some money into a central kitty ...
NICU Mortality Risk Adjustment Scores. NICHD 1993. SNAP. SNAP-PE. CRIB. SNAP II. SNAP-PE II. CRIB II. VON-RA. NICHD 2008. NQI-2 ... Methods of Mortality Risk Adjustment in the NICU: A 20-Year Review. Stephen W. Patrick, Robert E. Schumacher, Matthew M. Davis ... Methods of Mortality Risk Adjustment in the NICU: A 20-Year Review ... Methods of Mortality Risk Adjustment in the NICU: A 20-Year Review ...
risk adjustment. Introduction. How are we to evaluate outcomes for the care that we provide, and how are we to benchmark ... Challenges in Risk Adjustment for Hospital and Provider Outcomes Assessment. William S. Weintraub, Kirk N. Garratt ... and standards for statistical adjustment have been developed.1 As a result, performance reports based on data from both ... and comorbidities using statistical methods that risk adjust to create fairer comparisons.1 Concerns now focus on metrics such ...
Ive fixed my earlier post on competitive risk adjustment. Mistakes happen and I had a whopper in it. But thats gone now and ... Its good to have something in mind that might improve risk adjustment. If standard risk adjustment approaches turn out to be ... Ive fixed my earlier post on competitive risk adjustment. Mistakes happen and I had a whopper in it. But thats gone now and ...
Juju searches jobs from 1,000s of sites to make your OptumCare Risk Adjustment Healthcare job search faster and more ... All OptumCare Risk Adjustment Healthcare jobs in United States. ... risk . If you eat, breathe, and sleep risk adjustment like we ... Act as the Clinical Lead for Risk Adjustment and works collaboratively with the Risk Adjustment ... We at NAMM, a part of ... As the Optum Care National Risk Adjustment Healthcare Economics Team, we support all risk adjustment efforts across our ...
To develop a risk adjustment method for HbA1c, based solely on administrative data and to determine the extent to which risk- ... CONCLUSIONS: Risk adjustment using only administrative data resulted in substantial changes in identification of high or low ... The number of performance outliers was reduced as a result of risk adjustment. For mean HbA1c levels, 7 facilities that were ... Although our findings are exploratory, risk adjustment using administrative data may be a necessary and achievable step in ...
Adjustment Disorder Basics. Guides. Adjustment Disorder: Risk Factors. Children who experience frequent and severe stress are ... Adjustment Disorder: What to Look For. Next. Adjustment Disorder: Diagnosis. Adjustment Disorder Basics. *Adjustment Disorder: ...
... as well as data that were abstracted to calibrate the Medicare Mortality Predictor System to assess the usefulness of a risk ... adjustment system in interpreting hospital mortality rates. The majority of variation in annual hospital death rates for the ... Risk adjustment methods do not show whether the unexplained difference in mortality rates results from differences in ... The role of clinical risk adjustment JAMA. 1988 Dec 23-30;260(24):3611-6. ...
First of all, this paper makes a full sample study of the risk adjustment behavior of fund manager based on the funds first- ... and further studies the relationship between market state and fund managers risk adjustment behavior. Result: Fund managers ( ... Finally, pay incentives dominate in a bull market, prompting fund managers to increase the risk of their portfolios in the ... losers) with lower mid-year performance increase portfolio risk more than fund managers (winners) who are at the top of the mid ...
Risk Adjustment Program. The ACAs risk adjustment program creates a mechanism to protect against insurer risk selection, ... Risk adjustment creates an opportunity for health plans and providers to review coding practices and identify and correct ... This article, the first in a two-part series, focuses on risk adjustment and its affect on health plans and providers. ... Coding and Risk Score Accuracy. Complete and accurate reporting of diagnoses by physicians drives the accuracy of risk scores. ...
Currently, risk adjustment is used to move dollars from low-risk payers to relatively high-risk payers based on the health ... Assessing high-risk clients: Risk assessment is key for risk adjustment and it depends mostly on the traditional parameters ... Risk is calculated from the diagnosis and conditions already existing in the population or an individual. Risk adjustment is ... As prospective risk adjustment is mostly for the benefit of plans to accommodate high-risk members, predictions using the ...
... for the risk adjustment program, a sign the agency may be preparing to unfreeze the payments. ... Risk Adjustment healthcare policy Affordable Care Act (ACA) Centers for Medicare & Medicaid Services (CMS) Katie Keith Eric ... OMB is reviewing a rule from HHS aimed at ratification and reissuance of the risk adjustment methodology. (Sarah Stierch/CC ... The Trump administration is preparing to release a new regulation that could unfreeze $10.4 billion in risk adjustment payments ...
All clinical risk models can only partially account for risk and this must be borne in mind when interpreting risk-adjusted ... it is important to remember that a major pitfall in risk-adjustment is believing one has completely adjusted for risk. ... Risk adjustment for congenital heart surgery: the RACHS-1 method. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004;7: ... We are part of the research team that developed the empirical risk-adjustment method used by the National Institute of ...
Use of risk adjustment.... *Use of risk adjustment in setting budgets and measuring performance in primary care I: how it works ... Use of risk adjustment in setting budgets and measuring performance in primary care I: how it works BMJ 2001; 323 :604 ... Use of risk adjustment in setting budgets and measuring performance in primary care I: how it works. BMJ 2001; 323 doi: https ... Why did risk adjustment develop in the United States?. In the United States, there has been a gradual shift over the past 30 ...
Should it be included as a risk adjustment factor? ... Future in Risk Adjustment. This may sound crazy, but it seems ... Currently the FOTO risk adjustment model accounts for 35% variance. (Although 35% doesnt seem like a very large percent, its ... The current risk adjustment model is totally focused on the patient and patient factors. What excites me is this new study ... Whenever the outcome of your service is predicted, you want your data risk adjusted. Whenever your services are compared, you ...
An introduction to risk adjustment. Am J Med Qual. 1996; 11(1):S8-11. ...
Risk Adjustment for Sociodemographic Factors. This project seeks to develop a set of recommendations on the inclusion of ... and other factors such as race and ethnicity in risk adjustment for outcome and resource use performance measures. Read more ...
Risk adjustment, California style. Risk adjustment has been used successfully to create equity in health care in some regions ... Anders who advises the organization on risk adjustment.. "The question to ask isnt if risk adjustment can work but, rather, ... Whats the risk?. As more people are covered by some form of managed care, many in the industry are looking at risk adjustment ... "The purpose of risk adjustment isnt to cut costs so much as protect plans that get high risk," says Gilliam. "It shifts money ...
... has the potential to simplify risk-adjustment and provide a consistent and stable basis for risk-adjustment relative to the ... The agency-level analyses then were repeated using only the core risk-adjusters in the alternative risk-adjustment models. This ... In addition to the core, approximately 2-3 outcome-specific risk-adjusters were included in the final, full risk-adjustment ... Second, the relative ranking of agencies using current risk-adjustment models and the ranking using the full alternative risk- ...
Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report * Christopher M. Murtaugh, Ph ... Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report Opportunities to Improve ... Alternative Risk-Adjustment Approaches to Assessing the Quality of Home Health Care: Final Report 07/01/2006 ...
  • Additionally, we made a series of regulatory adjustments such as extending reporting deadlines, and delaying the implementation for a number of planned regulatory changes for the banks, insurers and private pension plans we supervise. (gc.ca)
  • They wield incredible powers and David is forced to risk everything if he wants to make his own choices. (didyouseethatone.com)
  • Below are some of the areas where a small adjustment can make an enormous difference to both the comfort and the appearance of a room. (paperblog.com)
  • Features such as fender-mounted cutting height adjustment, adjustable seat and an ergonomic steering wheel make these tractors simple and comfortable to operate. (redpowerteam.com)
  • To aid us in determining this, we will seek input from the sectors we supervise to make the necessary adjustments. (gc.ca)
  • You put $1 in, you might be able to make five or 10, but you can only risk one. (realvision.com)
  • For one, unlike keyboard shortcuts, you can set sensitivity and range for each dial allowing you to make those meticulous and detailed adjustments for even better looking results. (monogramcc.com)
  • Imagine everything that can happen (delivery time + courier time + time to clear customs + time to make adjustments) to calculate how far in advance you will need to buy your dress. (myeventboutique.com)
  • But if you make one small adjustment to the butterfly, you turn it into its cousin-an unbalanced, or broken wing, butterfly-with an entirely different risk profile. (tdameritrade.com)
  • During the course of the Company's third quarter financial statement closing process, items may be identified that would require the Company to make adjustments, which may be material, and as a result, the estimates included in the press release are subject to risks and uncertainties, including possible adjustments to preliminary operating results. (advfn.com)
  • Our dedicated staff provides customized business solutions to meet your specific needs and make adjustments as your business grows and changes. (dailygood.org)
  • On the Charged Heavy state, even though we nerfed the option select (see previous entry Charged Heavy Opener Adjustments ), we still like Conquerors to be able to pressure opponents by Charging and holding forward so we make it a bit faster in forward movement. (ubisoft.com)
  • We believe it is realistic to take a gradual and modest approach to policy adjustment, and there should be some flexibility given the uncertainties in global economics and geopolitics. (jpmorgan.com)
  • Large anti-slip surface: makes the BuggyBoard Safe and Comfortable to stand on - reduces the risk of your child accidentally slipping off their BuggyBoard. (babytems.com)
  • Reduces the risk of condensation. (pjoutdoors.co.uk)
  • Low thread tension reduces the risk of thread breakage. (unionspecial-gmbh.com)
  • Its durable construction withstands rough environments and the slim design reduces the risk of snagging in branches or confined areas. (snickersuk.com)
  • An ergonomic and stable heel cap locks the foot in the boot, anchors it to the midsole and reduces the risk of blisters. (alfaoutdoor.com)
  • Our data also indicates a conservative trend in the overall net adjustments, suggesting appraiser behavior that is designed to not appear overly aggressive or excessive. (appraisaltoday.com)
  • European farmers have and will have to adapt to a changing climate, through measures that go beyond simple adjustments to ad hoc practices. (fundacionglobalnature.org)
  • Insurance policies impose certain duties on the policyholder and there are clearly established adjustment practices. (allianceadjustment.com)
  • Although the authorities have taken ad hoc measures to curb acute exchange rate pressures during the summer, a stronger policy response is urgently needed to reduce external imbalances and mitigate risks. (upenn.edu)
  • Your goal should be to mitigate the risk of building a product nobody wants and needs, not to figure out the product details. (romanpichler.com)
  • and ex-auto estimates face a small downside risk. (marketnews.com)
  • However, atypical April weather gives a small downside risk. (marketnews.com)
  • Access control systems help minimize the risk of break-ins by offering enhanced security to limit building access to employees. (replacementglass.com)
  • By using this feature, they will be able to maximize their profits and minimize risk by diversifying their investment between numerous currencies. (encorechamberplayers.org)
  • Our core construct is to eliminate the IRS taxes and burdens and minimize your risk through our bespoke services organization's core construct. (dailygood.org)
  • In the next five years, we see smart contracts in the insurance sector being developed in relation to short term risks where there are clear parameters as to payment, the potential for disputes is low and the claims management process is uncomplicated or pre-determined. (nortonrosefulbright.com)
  • The 2nd presentation in TAM Webinar 17, Transportation Asset Management and Risk Management, discusses how Colorado Department of Transportation responded to a damaging flood and developed a Risk-Resiliency model to better protect assets. (erm-portal.com)
  • Bonus programs & Risk Adjustment/Management systems. (pcmsoftech.com)
  • Abraham Insurance are leaders in insurance broking and risk management. (abraham.co.nz)
  • A new risk management policy was unanimously passed at an emergency IFC gavel meeting Wednesday evening. (bradleyscout.com)
  • Although IFC voted and approved a new risk management policy, Interim Vice President of Student Affairs Nathan Thomas said the moratorium will be lifted within the next week. (bradleyscout.com)
  • The risk management policy will enforce a BYOB policy, only allowing those of legal age to bring alcohol, and prohibits hard alcohol to be consumed in open party rooms at fraternity parties. (bradleyscout.com)
  • While a BYOB policy was included of the previous risk management policy, it was never enforced, Kapustka said. (bradleyscout.com)
  • The Perfect Party, a training opportunity for greek members to experience what the ideal risk management-compliant party should look like, will be hosted at Pi Kappa Alpha (Pike) on Friday, Feb. 22. (bradleyscout.com)
  • The new risk management policy] really gives all of our chapters a fresh start and allows us to move forward," said Kapustka. (bradleyscout.com)
  • Risk management, Determination of individual safety requirements concerning conducted operations. (hsea.pl)
  • Adjustment of the HSE Management System to local conditions. (hsea.pl)
  • With another year behind us, it is important to take time to review your IRA's investments and evaluate if any adjustments should be considered to ensure that your holdings can produce your desired results. (azreia.org)
  • Having said that, it's ok to address key UX and technology risks and evaluate important user interaction and architecture options as part of the discovery work. (romanpichler.com)
  • Adjustment for diagnosis code variables resulted in estimates that were further from the null, in all time periods. (thenakedscientists.com)
  • This strategy solves several major challenges that options traders face including: positive Vega to control risk during (and even benefit from) volatility spikes, low capital and time requirement allowing traders to easily add the strategy without overcomplicating their lives, and steady returns even during wild markets girations. (thewsodownload.com)
  • We will continue to look forward when developing guidance and approaches that support reasonable risk taking but at the same time provides the necessary safeguards for depositors, policyholders and private pension plan beneficiaries. (gc.ca)
  • How much of your overall retirement portfolio should be placed into the "fixed income" bucket is driven by your age, risk-tolerance and time horizon. (azreia.org)
  • Slightly than tethering you to a selected class or two, flat-fee cards provide long-time period value no matter how your budget adjustments. (hellenesonline.com)
  • Because this will be the first time Bradley's IFC community will collectively follow a BYOB policy, Thomas said he expects there to be some difficult adjustments. (bradleyscout.com)
  • Be flexible with the sizes, adjustments, and cuts of old and used wedding dresses can be very different from today, so don't expect your usual size to be 100% equivalent to the piece. (myeventboutique.com)
  • Plus, it cuts down the risk that all of your information gets held up or shut down while you're trying to move it. (databerry.com)
  • With data fed into such technologies, policy adjustments could be made automatically in response to certain pre-determined events or information received. (nortonrosefulbright.com)
  • Ben Lindbergh has a piece at BP , that includes some quote-gathering and input from Jason Cole, about the mechanical adjustments Cotts has made, which includes quotes from Round Rock pitching coach Brad Holman, as well as gifs showing the changes that Cotts has made. (lonestarball.com)
  • What adjustments must be made by users, owners, and operators of the bulk power system in the new era of mandatory compliance? (fortnightly.com)
  • Third quarter net income of $71 million and income per diluted share of $.75, which included a negative adjustment of 11 cents/diluted share due to changes in some of the underlying assumptions re: the value of their service receivables (residual value of their securitizations), were up 20% and 21% respectively year over year. (andrewtobias.com)
  • To get your focus right, consider using a tool like my Product Vision Board to capture your idea, and identify assumptions and risks. (romanpichler.com)
  • Explore the key assumptions and risks in your product strategy and business model by systematically testing and addressing them in an iterative fashion using, for example, observations, interviews, surveys, and prototypes. (romanpichler.com)
  • Cancellation or non-renewal can only occur for specific reasons such as non-payment of premium or a substantial change in risk. (allianceadjustment.com)
  • An entity that applies the critical-terms-match method may subsequently "assess the effectiveness of a hedging relationship using a long-haul method when the critical terms change or adverse developments regarding the risk of counterparty default occur. (deloitte.com)
  • The "change in hedged risk guidance does not encompass allowing an entity to recharacterize its borrowing during the hedging relationship from a variable-rate instrument to a series of fixed-rate debt instruments and then to amend the designation to the variability of a benchmark rate component as the hedged risk. (deloitte.com)
  • just use the thumbscrew adjustment to change their size and gripping pressure. (electriduct.com)
  • But CBAMs pose significant implementation challenges and risks to global trading relationships, international climate agreements, and much needed climate-tech innovation. (gtipa.org)
  • Challenges: Facilitating external adjustment through a consistent set of policies is the key short-term priority. (upenn.edu)
  • As the public markets continue to experience increased volatility and a forecast of less than favorable conditions for the year ahead, investors with the foresight to redirect their nest egg into larger allocations of privately held alternative assets should help their chances of lowering their down side risk and injecting more stability into their retirement portfolios. (azreia.org)
  • A possible 11% reduction in overall care cost, adjusted for risk, is suggested by Union County's 2018 report. (dpcreferee.com)
  • Assessment and control of occupational risks for individual operations. (hsea.pl)
  • A multi-asset strategy with a balanced asset allocation that aims to offer capital growth and steady returns for investors that have a balanced attitude to risk. (1oakfunds.com)
  • The People's Bank of China (PBoC) might sit tight in terms of policy rates and required reserve ratios this year, while relying on macro-prudential measures to manage asset inflation risk. (jpmorgan.com)
  • Much research has addressed the question of how much money can safely be withdrawn from a retirement portfolio without prematurely running out of money (shortfall risk). (suny.edu)
  • While there's the risk of high-powered scopes being complex, the Trijicon's VCOG 1-6×24's ease of use impressed us. (allamericanreviews.com)
  • The FAIT strategy adopts a flexible approach to achieving an average 2% rate of inflation while avoiding pre-emptive rate hikes to counter perceived inflation risk associated with a falling unemployment rate. (jpmorgan.com)
  • In hindsight, we now know that inflation risk was not as pressing as the Fed's models suggested. (jpmorgan.com)
  • Aggressive home price inflation is still more of a threat today than the risk of a market crash in Toronto or Vancouver. (advantagemortgage.ca)
  • It seeks a package of measures which include a structural adjustment of 0.5% of GDP for the whole of next year (approximately 6 billion euros). (thecorner.eu)
  • Lack of risk adjustment means that the traders and their bosses are more likely to focus on risky short-term schemes that could damage the firm. (oecdinsights.org)
  • Some option traders choose to unwind such positions before expiration to help avoid these risks. (tdameritrade.com)
  • But there is a point for every individual where the level of risk is not worth the potential return, and what is right for one person may not be suitable for another. (harvestmywealth.com)
  • Individual adjustments for your needs. (africanpeople.info)
  • Allows individual adjustment of ankle and forefoot. (alfaoutdoor.com)
  • I think this new IFC risk policy shows how well our greek community can come together and create a policy that will keep not only our members safe but our guests as well," he said. (bradleyscout.com)
  • Creation of a good image of the company, Loss prevention and proactive policy in the areas where a failure can occur, Protection of employees through: providing safe working conditions, reducing occupational risks related to the performance of their duties. (hsea.pl)
  • Smart contract processes should reduce claims administration costs, the risk of fraudulent claims and lead to reduced administrative costs for the insurer. (nortonrosefulbright.com)
  • Most investors understand that as risk increases, the potential for return also increases. (harvestmywealth.com)
  • It's worth noting, however, to be aware of the risks as expiration approaches. (tdameritrade.com)
  • Thinner or crumple material will get higher risk of damage. (trueprint.com.sg)
  • Designed with needle nose, curved jaws, Triplett LongLockers can easily be used in small areas to grab tiny and even round objects, without risking damage or abrasion. (electriduct.com)
  • Results: The relative risk of death for vaccinated persons compared with unvaccinated persons was 0.39 [95% confidence interval (95% CI), 0.33 0.47] before influenza season, 0.56 (0.52 0.61) during influenza season, and 0.74 (0.67 0.80) after influenza season. (thenakedscientists.com)
  • It is clear that while conditions have become more stable, risks and uncertainty remain in the financial sector. (gc.ca)
  • In case you're not clear about what a lack of risk adjustment is, the report gives examples. (oecdinsights.org)
  • You can even control all adjustments in Lightroom with just one dial. (monogramcc.com)
  • Carbon Border Adjustment Mechanisms and Climate-Tech Innovation: A Happy Coupling? (gtipa.org)
  • It brings together French, Spanish, German and Estonian partners, who represent four areas constrained by different climatic risks. (fundacionglobalnature.org)
  • Three slim wearing positions reduce the risk of snagging in confined areas and allow a tight but comfortable seal. (snickersuk.com)
  • New rules, promulgated by the Federal Energy Regulatory Commission (FERC) in a host of areas, significantly have altered the regulatory risk landscape. (fortnightly.com)
  • 1. "Estimated Liquidation Price" replaces "Risk Level" as the only indicator for determining the risk of a position. (zendesk.com)
  • Further to our last communication, we are very pleased to announce that under the level 4 Risk-Adjusted Strategy for economic activity provided by Government, Rottner Security is permitted to trade and will be opening on Monday, May 11th. (rottner-security.co.za)
  • Those adjustments have helped the company cultivate three traits-speed, risk-taking, and accountability to customers-deemed essential to its success. (hbr.org)
  • You could try to present your own claim to the insurance company on your own but you would be taking a great risk. (allianceadjustment.com)
  • Bank B doesn't have to carry the risk either, and can underwrite it with a reinsurance company entirely outside the banking system, and not subject to its rules. (oecdinsights.org)
  • Ireland has the most flexible and open economy in the periphery of the eurozone, and its 'economic adjustment process is further advanced than in the other sovereigns currently experiencing market pressures. (euinside.eu)
  • A point on Spanish economic adjustment by Tyler Cowen, Marginal Revolution , September 30, 2013. (openborders.info)
  • While we hope this virus will be eradicated soon, CAS has taken measures to reduce the risk to its employees and clients. (casnc.com)
  • The heel shape is designed to reduce the risk of blisters. (alfaoutdoor.com)
  • Insurance transactions where the actual payment trigger and contractual flow in relation to the insurance risk are simple, but which feature high upfront structuring and ongoing costs for both the beneficiary and underwriters as a result of having multiple participants or simply a complex structure, seem obvious candidates for the deployment of smart contracts. (nortonrosefulbright.com)
  • The first part gives an overview of how healthcare Risk Pools actually work and why quarantining sick people into a separate High Risk Pool is such a terrible idea. (acasignups.net)
  • Part 1 went over the basics of how risk pools work in general , and why segregating sick people into a separate pool is a terrible idea. (acasignups.net)
  • S&P warns that " a reform process based on a pillar of fiscal austerity alone risks becoming self-defeating. (euinside.eu)
  • Moreover, there is an increased risk of 'reform fatigue' , particularly in countries with a deep recession and bleak growth prospects. (euinside.eu)
  • If you're comfortable with a stock position, or the risk of getting a stock position, fine. (tdameritrade.com)