Recorded presentation

Margaret Gerteis, PhD¹, Rosemary Lee, RN², Fiona D. Smith, MPH¹, Keith Cherry, PhD¹, Alyson Ward, MPH¹, Jessie Gerteis¹, Phyllis Nagy², and Christopher Koepke, PhD³. (1) Health Services Research and Policy Group, BearingPoint, 99 High Stret, Boston, MA 02110, 617-988-1331, mgerteisphd@bearingpoint.net, (2) Centers for Medicare & Medicaid Services, 7500 Security Blvd, Baltimore, MD 21244, (3) Center for Beneficiary Choices, Centers for Medicare & Medicaid Services, 7500 Security Blvd., Mailstop S1-15-03, Baltimore, MD 21244-1850

Objective: To inform the CMS’s social marketing strategies for promoting publicly-reported measures of nursing home and home health quality, by assessing consumers’ understanding of quality; perceptions of choice; patterns of decision-making; and the role of information intermediaries.

Methods: Focus groups, in-depth interviews, dyads, and cognitive interviews with Medicare beneficiaries, family caregivers, hospital discharge planners, physicians, nursing home and home health professionals, elder services organizations, trade associations, and consumer advocacy organizations in multiple geographic settings.

Results: Family caregivers make decisions around nursing home placement but resist taking action until they are in crisis. Medicare beneficiaries and family caregivers (“consumers”) perceive that doctors and hospitals make decisions around home health placement and that consumers have little or no choice. Consumers are aware of variations in nursing home quality, but they have little understanding of such differences among home health agencies. Consumers perceive quality in terms of personal qualities of professional staff and the physical nursing home environment, rather than clinical outcomes or functional status. They have difficulty understanding quality measures as indicators of organizational performance.

Conclusions: Consumers perceive limited choice and/or opportunity to plan in advance. They have difficulty understanding clinical measures of quality or their usefulness to placement decisions. Findings raise questions about the salience of promoting quality reporting directly to consumers and suggest targeting intermediaries as a primary audience.

Learning Objectives:

• · Identify patterns of decision-making in nursing home and home health placements;
• · Explore consumers’ perceptions of quality in nursing homes and home health care;
• · Explore consumers’ understanding of quality measures and their perceived usefulness.

Keywords: Social Marketing, Quality Improvement

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation