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APHA Scientific Session and Event Listing

Dana B. Mukamel, PhD¹, William D. Spector, PhD², David L. Weimer, PhD³, Jacqueline S. Zinn, PhD⁴, Heather A. Ladd, MS¹, and Kimberly I. Edgcomb, MA¹. (1) Dept. of Medicine, Center for Health Policy Research, University of California, Irvine, 111 Academy, Suite 220, Irvine, CA 92697, 949 824 9973, dmukamel@uci.edu, (2) Agency for Healthcare Research & Quality, 540 Gaither Road, Room 5125, Rockville, MD 20850, (3) LaFollette School of Public Affairs, University of Wisconsin - Madison, 1225 Observatory Drive, Madison, WI 53706, (4) Fox School of Business & Management, Temple University, 413 Ritter Annex, Philadelphia, PA 19122-6091

In November 2002, the CMS published for the first time a web based report card that includes information about the quality of care provided by all Medicare and Medicaid certified facilities in the country. This report card, which is part of the CMS Quality Initiative, is intended to offer information about quality to consumers and nursing home providers, help prospective residents and their families choose high quality facilities, and by making the demand for care more sensitive to quality, provide incentives to nursing homes to improve their quality. In this study we assessed the impact of the publication of the report card on quality of care by comparing 6 quality measures in the year prior to and the year following publication. The measures included: increase in ADL limitations, infections, restraints, pressure ulcers, pain for short-stay residents, and walking for short-stay residents. We calculate quality measures for 4 quarters prior to publication and 5 post publication. We estimate multivariate regression models in which the dependent variable is the quality measure at time t, and independent variables included the facility's published quality score relative to its competitors (based on the first publication in November of 2002), competition and other variables likely to influence quality such as type of ownership and local demand. Panel regression techniques, allowing for autocorrelation and clustering within states are used. Results show that quality has improved for some of the measures, but not all. Implications will be discussed.

Learning Objectives:

Participants will
• Become familiar with the Medicare Nursing Home Compare report card.
• Gain an understanding of the factors that influence the effectiveness of the reprot card
• Will learn if the report card has made a differnece to quality of nursing home care, in the short run.

Keywords: Quality of Care, Nursing Homes

Presenting author's disclosure statement:

Any relevant financial relationships? No