Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107448

Brian E. O'Donnell, PhD, Kathleen Schneider, PhD, and Debbie Dean, MS. Health Informatics, Iowa Foundation for Medical Care, 6000 Westown Parkway, West Des Moines, IA 50266, (515) 440-8619, kschneid@ifmc.org

The Centers for Medicare & Medicaid Services (CMS) began publicly reporting nursing home (NH) and home health agency (HHA) quality measures on the Medicare Web site (www.medicare.gov). The primary purpose of reporting quality measures to the public was to provide consumers with sufficient information to make informed decisions when selecting NHs and HHAs. At the time this special study was launched, provider performance rates were not publicly reported if sample sizes did not meet the minimum sample size requirements. Therefore, data were not reported for all providers in a state. CMS contracted with the Iowa Foundation for Medical Care (IFMC) to explore alternative statistical options for public reporting data from providers with small samples. Rates derived from small samples tend to be unstable. The concern with presenting this information publicly is it may not accurately represent true provider performance. However, if it is suppressed, small providers will be less accountable for their performance than larger providers. In this presentation, IFMC will discuss methodological alternatives to publicly reporting performance rates. Statistical and practical implications of adopting the particular alternatives will be discussed. The options reviewed include: various methods of aggregating over time, parametric and non-parametric inferential statistics, and a variety of modeling techniques. Some of these strategies were empirically tested using national NH and HHA data. Results of these analyses and highlights of the technical expert panel discussions will be shared. This work will inform future CMS reporting decisions across various health care settings.

Learning Objectives:

• We will examine statistical and methodological alternatives to the current public reporting strategies.
• Understand how the methods may be applied to various health care settings.

Keywords: Health Care Quality, Data/Surveillance

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF work on some contracts with the Centers for Medicare and Medicaid Services (CMS).

Recorded presentation