Andrew Martin Maxfield, PhD1, Elizabeth Goldstein, PhD2, Christopher Koepke, PhD3, Phyllis Nagy2, Rosemary Lee, RN2, Myra Tanamor, MPP4, Mary Laschober, PhD4, and Lauren Blatt4. (1) Consultant, 1666 Kalorama Rd., NW, Washington, DC 20009, 202-387-4738, firstname.lastname@example.org, (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, (4) BearingPoint, 1676 International Drive, McLean, VA 22102
Objective: The Nursing Home Quality Initiative (NHQI) and the Home Health Quality Initiative (HHQI) are efforts by the Centers for Medicare & Medicaid Services to improve the quality of nursing care and home health care. This study assesses one component of the Initiatives in which hospital discharge planners (HDPs) were encouraged to act as “infomediaries” by using quality measures in their counseling with consumers.
Methods: In evaluating the first phase of the HHQI, randomly selected HDPs (N=504) in eight intervention states and six comparison states were surveyed before the intervention. Panel and independent samples of HDPs (504 total) were surveyed following the intervention. Randomly selected HDPs (N=341) were surveyed after an NHQI intervention in six states.
Results: The Initiatives had some success at raising awareness of the quality measures among hospital discharge planners but less success at increasing their use of the measures. Use of the measures depended on how HDPs were exposed, decision-making within hospitals, hospital affiliations, and HDP demographic, behavioral and attitudinal factors. HDPs rely on direct communication with service providers, cite time as a barrier, and question the accuracy and utility of the measures.
Conclusion: The HDP “infomediary” model has promise, but CMS will need to enhance its outreach to HDPs through tailored communications that address organizational, and individual behavioral and attitudinal constraints.
Keywords: Medicare/Medicaid, Evaluation
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Center for Medicare & Medicaid Services
The 132nd Annual Meeting (November 6-10, 2004) of APHA