Edwin D. Huff

Edwin D. Huff
U.S. Department of Health and Human Services | HHS · Centers for Medicare and Medicaid Services

Ph.D. Community & Social Psychology

About

74
Publications
44,574
Reads
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1,282
Citations
Citations since 2017
8 Research Items
224 Citations
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Introduction
Health Care Quality Measurement, Quality of Healthcare Measurement, Timely Treatment, Fistula First Breakthrough Initiative, Renal recovery in End Stage Renal Disease, Acute Kidney Injury, Surgeon Profiling, Healthcare Disparities in Chronic Kidney Disease, Crown Web (Consolidated Renal Operations in a Web-Enabled Network). Covid-19 in ESRD.
Additional affiliations
January 1998 - present
Centers for Medicare & Medicaid Services
Position
  • Science Officer, Government Task Leader, and Contract Officer Technical Representative III
Description
  • Currently manage 4 contractors, 3 Quality Improvement Organizations (QIOs) in New England, and 1 End Stage Renal Disease Network in 3 Mid Atlantic states and DC. Co-leading a Project testing Peer-to-Peer ESRD Patient support for reducing hospitalizations.
July 1997 - December 1998
Value Options Behavioral Health
Position
  • Statistician
June 1992 - February 1997
Northeast Healthcare Quality Foundation
Position
  • Director Project Development and Analysis
Education
August 1977 - June 1984
Boston College
Field of study
  • Community and Social Psychology
June 1968 - June 1973
Clemson University
Field of study
  • Math & Psychology

Publications

Publications (74)
Article
Full-text available
To test whether conventional data reliability assessment overestimates reliability, an assessment and a comparison of the reliability of complex quality indicators and their simpler components were conducted. Medical records of 1078 Medicare cases with principal diagnoses of initial episodes of acute myocardial infarction (AMI) were independently r...
Article
Full-text available
Case counts below 50 can compromise the careful use of disease- or procedure-specific standardized mortality ratio comparisons across small hospitals in predominantly rural areas. Linking data series where data are of the same quality and are continuous across the series is one way of handling the problem of small case sizes. Examination of three d...
Article
Full-text available
To demonstrate the use of quality indicators developed through claims data augmentation. A retrospective examination of field-tested acute care quality indicators and methods used in developing them to identify opportunities for quality improvement was used. The settings were 46 acute care hospitals and physician staffs serving Medicare beneficiari...
Article
Full-text available
Rationale & Objective Anemia management in maintenance dialysis patients remains a challenge. We sought to update information in this area by evaluating the association between hemoglobin and various outcome and utilization measures using data-rich Medicare sources. Study Design Observational cohort study using data from the Consolidated Renal Ope...
Article
Full-text available
This article describes an estimated 6953–10 316 excess deaths among individuals with end-stage renal disease during the early months of the COVID-19 pandemic in February 2020–August 2020 (compared to death rates prior to the pandemic). Notably, the estimated number of excess deaths was reported as 10.8–16.6 per 1000 individuals on dialysis and 2.6–...
Article
Full-text available
End-stage renal disease (ESRD) is a condition in which kidney function has permanently declined such that renal replacement therapy* is required to sustain life (1). The mortality rate for patients with ESRD in the United States has been declining since 2001 (2). However, during the COVID-19 pandemic, ESRD patients are at high risk for COVID-19-ass...
Data
InfoGraphic showing U.S. Disparity in Anemia for Blacks.
Technical Report
Full-text available
An increasing national trend from 2006 - 2015 displays a marked rise in low levels of monthly monitored Hemoglobin < 10 g/dl for End stage renal patients. Within this rising trend, a disparity has been identified with markedly higher trends of low hemoglobin being associated with African American ESRD patients. https://www.ahrq.gov/research/finding...
Technical Report
Full-text available
For the 15th year in a row, AHRQ is reporting on healthcare quality and disparities. The annual National Healthcare Quality and Disparities Report (QDR) is mandated by Congress to provide a comprehensive overview of the quality of healthcare received by the general U.S. population and disparities in care experienced by different racial and socioeco...
Article
Full-text available
A patient-centered quality improvement program implemented in one Virginia hemodialysis facility sought to determine if peer-to-peer (P2P) programs can assist patients on in-center hemodialysis with self-management and improve outcomes. Using a single-arm, repeatedmeasurement, quasi-experimental design, 46 patients participated in a four-month P2P...
Technical Report
Full-text available
AHRQ Annual Report Shows More Americans Have Health Insurance and Receive Safer Care, but Gains Remain Uneven Among Minorities: AHRQ’s 2016 National Healthcare Quality and Disparities Report shows that the quality of health care continues to improve gradually each year but gains remain uneven among minorities. Some of the biggest improvements are i...
Technical Report
Full-text available
 Through 2013, across a broad spectrum of measures of health care quality, 60% showed improvement (black).  About 80% of measures of Person-Centered Care improved.  About 60% of measures of Effective Treatment, Healthy Living, and Patient Safety improved.  Fewer than half of measures of Care Coordination improved.  There are insufficient numbe...
Technical Report
Full-text available
AHRQ’s Chartbook on Health Care for Blacks, derived from the National Healthcare Quality and Disparities Report, summarizes trends in health care disparities by race related to access, Heckler Report priorities, and National Quality Strategy priorities. Key findings include increases in suicide and mental health disparities, improvements in access...
Article
Objectives: The relationship between mortality and pre-ESRD (end-stage renal disease) nephrology care in incident ESRD patients with multiple myeloma (MM) as the primary cause of renal failure has not been examined. Materials and methods: Among 439,206 incident US hemodialysis patients with MM as the primary cause of ESRD (June 1, 2005 to May 31...
Research
Full-text available
A descriptive statistical analysis of variation in termination turnover rates of employees at the Department of Social Services, the Massachusetts state service agency which employs social workers to assist dysfunctional families. Produced in 1983, the report gives examples of simple, yet powerful comparative analyses that can help in most any form...
Technical Report
Full-text available
New AHRQ Report: Quality of Care and Patient Safety Are Improving, Particularly for Hospital Care, Though Additional Work Remains The overall quality of health care and patient safety are improving, particularly for hospital care and for measures that are being publicly reported by the Centers for Medicare & Medicaid Services, according to the newl...
Book
Full-text available
From Highlights: What Is the Status of Health Care Quality? "Based on this composite (of 48 measures), quality of health care in America is only fair. On average, in 2010, Americans received 70% of indicated health care services and failed to receive 30% of the care they needed to treat or prevent particular medical conditions. The gap between best...
Book
Full-text available
From Highlights: ..."Disparities in quality of care are common: o Blacks and Hispanics received worse care than Whites for about 40% of quality measures (Figure H.7). o AI/ANs received worse care than Whites for one-third of quality measures. o Asians received worse care than Whites for about one-quarter of quality measures but better care than Whi...
Article
Full-text available
Background: Patients started on long term hemodialysis have typically had low rates of reported renal recovery with recent estimates ranging from 0.9–2.4% while higher rates of recovery have been reported in cohorts with higher percentages of patients with acute renal failure requiring dialysis. Study Design: Our analysis followed approximately 19...
Data
The attached text file contains comments that were hoping to elicit research authors' feedback concerning a report of weak associations between measures of surgical quality and patient outcomes, including readmission and mortality rates. The comments (letter to editor) were not accepted for publication for unclear reasons. I felt the point made in...
Data
The attached file is an unpublished letter to the editor that finds fault with the vague definition of primary treatment (non-transfers) used in analyses of timely treatment for AMI. The authors showed modest improvement in door-to-needle time for treating AMI with PCI, though with unremarkable outcome improvements. They could have used a definitio...
Data
These are slides for the presentation given at the Tri Regional Conference about Change efforts in Inpatient Quality Improvement.
Data
This lecture included a review of measurement methods found in the Quality Improvement Organization's (QIO) 7th Scope of contracted Work for the Centers for Medicare & Medicaid Services (CMS). These same measures were also being reported in the Agency for Health Care Research and Quality's (AHRQ) National Health Care Quality Reports. After review o...
Data
Full-text available
This pdf file is a 8.5" x 11 " page which can be seen as a poster image, if downloaded and viewed. Abstract: Research Objective: To evaluate a new measurement system implemented by a large government agency, to reduce acute care payment errors - to enable organizational learning about implementing such systems. Study Design: An empirical assessme...
Chapter
Full-text available
Use of Arteriovenous Fistula at First Outpatient Dialysis For people with ESRD, dialysis can accommodate for lost kidney function by balancing minerals and water in the blood and removing waste. Vascular access is needed to reach blood vessels so that dialysis can be performed. An AVF is the preferred type of access for most hemodialysis patients f...
Chapter
Full-text available
From 2008 to 2011, the percentage of dialysis patients who used an AVF at first dialysis increased from 13.7% to 15.8% (Figure 2.16). In all years, Blacks had lower rates of AVF at first dialysis than Whites, and Hispanics had lower rates than non-Hispanic Whites. The 2008 top 5 State achievable benchmark was 27%. Overall, this benchmark could not...
Data
As described in https://www.researchgate.net/publication/13140640_Developing_quality_of_acute_care_indicators_through_claims_data_augmentation this two variable data set contains over 8,000 sorted principal diagnosis codes, using ICD-9 coding, and their associated analytical category value, representing risk of mortality at 14 days post dischar...
Data
See other supplemental abstract on "Principal Diagnoses and associated Analytical Categories" for file description.
Article
Adequate pre-dialysis care reduces mortality among end-stage renal disease (ESRD) patients. We tested the hypothesis that individuals with ESRD due to sickle cell disease (SCD-ESRD) receiving pre-ESRD care have lower mortality compared to individuals without pre-ESRD care. We examined the association between mortality and pre-ESRD care in incident...
Article
Full-text available
Background: Lok et al previously reported a risk equation for arteriovenous fistula (AVF) maturation failure. It is unclear whether this model or a more comprehensive model correlates with incident AVF use in the US hemodialysis population. Study Design: Cross-sectional study. Setting & Participants: 195,756 adult patients initiating outpatient hem...
Chapter
Full-text available
Health care quality and access are suboptimal, especially for minority and low-income groups.Quality is improving; access and disparities are not improving. Urgent attention is warranted to ensure continued improvements in quality and progress on reducingdisparities with respect to certain services, geographic areas, and populations, including: o D...
Chapter
Full-text available
www.ahrq.gov/qual/qrdr11.htm Health care quality and access are suboptimal, especially for minority and low-income groups. Quality is improving; access and disparities are not improving. Urgent attention is warranted to ensure continued improvements in quality and progress on reducing disparities with respect to certain services, geographic areas,...
Article
Full-text available
Lok et al previously reported a risk equation for arteriovenous fistula (AVF) maturation failure. It is unclear whether this model or a more comprehensive model correlates with incident AVF use in the US hemodialysis population. Cross-sectional study. 195,756 adult patients initiating outpatient hemodialysis therapy in the United States between Jul...
Conference Paper
Background: ESRD has meant “Loss of kidney function, with need for kidney replacement treatments”, however, as evidence will show, some patients may not actually be afflicted with ESRD in the first place, and may instead be individuals suffering from types of acute kidney injury. Methods: A total of 205,399 incident ESRD hemodialysis patients from...
Conference Paper
Background: Given variation in practice patterns in many areas of medical care we inquired into the possible existence of similar variation among specialists treating ESRD patients. If specialists of fistula placements can be distinguished within ESRD Networks, it may be possible to increase referrals for such placements and increase fistula placem...
Conference Paper
Background: Interventions to improve maturation or prolong the function of HD access are common. Interventional radiologists (IR) have traditionally done these services in hospitals. Recently, internists/interventional nephrologists (IN) and access surgeons (AS) have begun to perform these access salvage procedures. The extent of this shift in prac...
Conference Paper
Background: Acute kidney injury is associated with an increased risk of end stage renal disease and a higher mortality, particularly in patients with underlying CKD. The need for continued renal replacement therapy (RRT) at the time of discharge from a hospitalization for an episode of acute renal failure (ARF) has increased over time. Acute Tubula...
Article
In the mid-1990s, significant gaps existed in the quality of acute myocardial infarction (AMI) care between rural and urban hospitals. Since then, overall AMI care quality has improved. This study uses more recent data to determine whether rural-urban AMI quality gaps have persisted. Using inpatient records data for 34,776 Medicare beneficiaries wi...
Conference Paper
Attendees will learn about the Centers for Medicare & Medicaid Services most recent Healthcare Disparity Reduction Initiatives through its Quality Improvement Program. Future ideas currently being weighed for future deployment in the near term will be presented. The 2006 National Healthcare Disparities Report, produced by a team of collaborating fe...
Article
Full-text available
Studies have shown improvement in quality of health care in the United States. However, the factors responsible for this improvement are largely unknown. To evaluate the effect of the Medicare Quality Improvement Organization (QIO) Program in 4 clinical settings by using performance data for 41 quality measures during the 7th Scope of Work. Observa...
Technical Report
Full-text available
"[While] Overall health care spending from 1997 to 2003 increased annually 7.47%, quality of care remained largely unchanged..."
Conference Paper
Full-text available
A conference presentation and panel update on experiences of 5 QIOs participating in QIO Best Practice Methods (BPM) special study: Provide background information Highlight 1st year outcomes Highlight 2nd year learning related to 8th SOW Share broader learning, recommendations for QIO community Panel Q&A
Conference Paper
Research Objective: To summarize the quality of health care for Medicare recipients based on findings from the second National Healthcare Quality and Disparities Reports. Key findings will be presented in three parts: a) findings on measures used by the Medicare program for quality reporting and monitoring of hospital, nursing homes, home health ag...
Conference Paper
A lecture by Dr. Edwin Huff, science officer and government task leader, Division of Clinical Standards and Quality, Centers for Medicare and Medicaid Services.
Conference Paper
Full-text available
As Government Task Leader of this multi year, $3 million Special Study, working with 5 QIOs, we addressed: Whether there were any high performing QIO Best Practices, and if so, what were they, and could they be replicated. Method: A targetted set of in depth surveys and interviews were conducted and analyzed for distinctions, across pre selected gr...
Conference Paper
Full-text available
This presentation summarized work done on improving healthcare quality in group of hospitals in Maryland by assessing and then, deliberately setting goals to improve an organization's effectiveness, by changing its culture.
Conference Paper
Full-text available
In this report, the background information on quality measurement in a rural hospital context is reviewed first. A description is provided next, of the field study methods, sample recruitment, training, inter-rater reliability assessment, the data collection for quality measures, and hospital staff surveys about the quality measurement process. In...
Article
Full-text available
Executive Summary The primary question addressed by this work was whether differences could be found in internal and external organizational behavior between QIOs whose states scored significantly above and below the national averages on the Centers for Medicare & Medicaid Services (CMS) 6th Scope-of-Work (6th SOW) inpatient quality measures at rem...
Article
Full-text available
Response to authors suggesting use of composite measurement as a better way to summarize performance improvement.
Article
Context: Despite widespread concern regarding the quality and safety of health care, and a Medicare Quality Improvement Organization (QIO) program intended to improve that care in the United States, there is only limited information on whether quality is improving. Objective: To track national and state-level changes in performance on 22 quality in...
Article
Full-text available
Despite widespread concern regarding the quality and safety of health care, and a Medicare Quality Improvement Organization (QIO) program intended to improve that care in the United States, there is only limited information on whether quality is improving. To track national and state-level changes in performance on 22 quality indicators for care of...
Conference Paper
Full-text available
When Measurement Gets in the Way Edwin Huff, Ph.D., M.A., B.A. Presented by: Edwin Huff, Ph.D., M.A., B.A., Science Officer, Division of Clinical Standards and Quality, CMS, rm. 2350, JFK Federal Building, Gov't Center, Boston, MA 02203; Tel: (617) 565- 3309; Fax: (617) 565-4835; E-mail: EHuff37855@aol.com, EHuff@cms.hhs.gov Research Objective: To...
Conference Paper
Presented by: Edwin Huff, Ph.D., M.A., B.A., Science Officer, Division of Clinical Standards and Quality, Centers for Medicare and Medicaid Services, Rm. 2350, JFK Federal Building, Gov't Center, Boston, MA 02203; Tel: (617) 565-3309; Fax: (617) 565-4835; Email: EHuff@cms.hhs.gov, EHuff37855@aol.com Research Objective: To assess quality of measure...
Conference Paper
Presentation Goals: Describe from Remeasurement and TQIP (change Intervention) Event data, “What Happened?” during the Sixth Scope of Work, with emphasis on national Task 1- Inpatient Improvement Results, and QIO activities An begin to explore “What things influenced what happened?”, including both “Nature” and “Nurture” factors, with a focus on th...
Article
Full-text available
Access to outpatient services within the first 30 days after an inpatient mental health episode may influence relapse risk. A retrospective cohort of 3,755 adult Medicaid mental health inpatients discharged from their first managed care acute episode of care from July 1, 1996, through May 20, 1998, were studied. Results showed patients' utilization...
Conference Paper
Full-text available
The Health Care and Financing Administration (HCFA (renamed Centers for Medicaid and Medicare Services)(CMS)) has initiated an ambitious, performance based, national healthcare quality improvement agenda for the Medicare Peer Review Organizations (PROs (renamed Quality Improvement Organizations)(QIOs)) during their current three-year contract (10/9...
Conference Paper
Full-text available
Lecture presentation on the effect of Structural factors on Timely Treatment. Structural factors included: Time frames of admission for AMI, Community Acquired Pneumonia (CAP) and Urinary Tract Infections (UTI) - Weekday vs. Weekend admission day, and Arrival Work Shift time frame; and, Hospital Peer Group (size) - Small rural, and Urban Hospitals...
Data
These powerpoint slides go along with the lecture presentation on Impediments to timely treatment for AMI, CAP and UTI, at the Harvard School of Public Health. They show how time of patient arrival, represented by hospital work shift, and day of the week (weekday vs. weekend), and hospital size peer group, impact patterns of timely treatment.
Article
Full-text available
To the Editor: Had Dr Hofer and colleagues1 or Dr Bindman2 acknowledged any of the limitations in the study of physician profiling, their presentations would have been more balanced, and thereby encouraged greater sympathy for physicians at risk of deselection due to inept profiling. Only 1 of 4 profiling measures, glycemic control, is a quality in...
Data
To ensure the representativeness of samples drawn from Task One populations for the four Acute Care Clinical Topics, a sampling validation project was proposed and executed. Comparisons between population and sampled cases on key demographic variables were made for each state or territory, for each of four clinical topics (53 x 4 = 212): Atrial Fib...
Article
To the Editor.—Dr Iezzoni1 compared risk-adjustment methods for use with mortality outcomes and discussed how we cannot live with them or without them. In doing so, the author revealed apparent gaps in experience and understanding of current practices in quality improvement that in fact misrepresent much of it. That work today may or may not use ri...
Article
To the Editor. —In reporting no apparent difference between declining coronary artery bypass graft (CABG) surgery mortality rate trends in Massachusetts and in New York and northern New England, Dr Ghali and colleagues1 have identified something that could be characterized as embarrassing or, at least, surprising. What makes their conclusions diffi...
Article
To the Editor —In reporting no apparent difference between declining coronary artery bypass graft (CABG) surgery mortality rate trends in Massachusetts and in New York and northern New England, Dr Ghali and colleagues¹ have identified something that could be characterized as embarrassing or, at least, surprising. What makes their conclusions diffic...
Article
Full-text available
To the Editor —Groundbreaking though their work is, Dr Bates and colleagues¹ and Dr Leape and colleagues² may have collectively oversimplified the management tasks for reducing adverse drug events (ADEs). By launching into computerized systems changes without a deeper understanding of medication delivery process stability, they also encourage manag...
Article
Full-text available
To the Editor: The article by Jollis et al. (Dec. 15 issue)[ 1] concerning the relation between the annual volume of percutaneous transluminal coronary angioplasty (PTCA) procedures and mortality is incomplete and misleading. Data on Medicare admissions for PTCA from October 1991 through June 1994 in New Hampshire suggest that Jollis et al. disrega...
Article
To the Editor. —The key finding recently reported by Dr Miller and colleagues1 and featured as an Original Contribution was previously described.2 However, the previous interpretation was very different.The significant inverse relationship between likelihood of hospitalization and all-cause, 30-day, postadmission-modeled mortality (the hospital sa...
Article
Full-text available
To the Editor: Joilis and colleagues (Ij draw conclusions regarding claims versus database discordance that extend beyond their data. (See full text.) References 1, Jollfs JG, Anculuewicz M, DeLong ER, Pryor DB, Muhlbaier LH, Mark DB, Discordance of databases designed for claims payment versus clinical information systems: Implications for outcome...
Article
Full-text available
A Featured Article, published 1987, in "Careers and the MBA", Adams Media Corporation, Avon Massachusetts. It's about Quality Management training and emerging business issues around managing product and service quality, targeted for MBA students. It is based on research from the Harvard Business School, and quality theory from Dr. W. Edwards Deming...
Conference Paper
Full-text available
A survey of single women in the Greater Boston area assessed the differential impact of social supports, self perceived social deviance, marital status and other various social demographic influences on self reported depressive symptoms.

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