Nearly One In Five Skilled Nursing Facilities Awarded Positive Incentives Under Value-Based Purchasing.

Medicare's Skilled Nursing Facility Value-Based Purchasing Program, which awards value-based incentive payments based on hospital readmissions, distributed its first two rounds of incentives during fiscal years 2019 and 2020. Incentive payments were based on achievement or improvement scores-whichever was better. Incentive payments were as low as -2.0 percent in both program years and as high as +1.6 percent in FY 2019 and +3.1 percent in FY 2020. In FY 2019, 26 percent of facilities earned positive incentives and 72 percent earned negative incentives, compared with 19 percent positive and 65 percent negative incentives in FY 2020. Larger, rural, and not-for-profit facilities were more likely to earn positive incentives, as were those with the highest registered nurse staffing levels. Although these findings indicate the potential to reward high-quality care at skilled nursing facilities, intended and unintended outcomes of this new value-based purchasing program should be monitored closely for possible program refinements, particularly in light of the disproportionate impacts of coronavirus disease 2019 (COVID-19) on nursing facilities.

pH/potential-responsive large aggregates from the spontaneous self-assembly of a triblock copolymer in water.

A simple triblock copolymer, mPEG750-aniline pentamer-mPEG750, was prepared by condensation polymerization. The solubility of aniline pentamer in this kind of copolymer was improved in common solvents especially in aqueous solution, and the electroactivity of this copolymer was confirmed by UV-vis and CV in aqueous solution. When aniline pentamer was in its emeraldine state, the copolymer spontaneously self-assembled into large spheres (with diameters up to 1000 nm) in acidic aqueous solution (pH < 3), and into microspheres (with diameters of about 300 nm) in alkali aqueous solution, while the size of the aggregates decreased with the increase of pH. For reversible transition between the large spheres and microspheres under the change of the pH and potential, which changed the doping state and the oxidation state, respectively, the copolymer has potential applications in sensors, controlled drug release, and so forth.