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Performing Well on Nursing Home Report Cards: Does It Pay Off?

Authors

  • Jeongyoung Park,

    1. American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106
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    • Address correspondence to Jeongyoung Park, Ph.D., Health Services Researcher, American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106; e-mail: jpark@abim.org. R. Tamara Konetzka, Ph.D., Assistant Professor, is with the Department of Health Studies, University of Chicago, Chicago, IL. Rachel M. Werner, M.D., Ph.D., Assistant Professor, is with the Center for Health Equity Research and Promotion, Philadelphia VAMC, Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA.

  • R. Tamara Konetzka,

    1. Department of Health Studies, University of Chicago, Chicago, IL
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  • Rachel M. Werner

    1. Center for Health Equity Research and Promotion, Philadelphia VAMC, Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA
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Abstract

Objective. To examine whether high performance or improvement on quality measures leads to economic rewards for nursing homes in the presence of public reporting.

Data Sources. Data from 6,286 freestanding Medicare-certified nursing homes between 1999 and 2005 were identified in Medicare Cost Reports, Minimum Data Set, and Online Survey and Certification Reporting System.

Study Design. Using a facility-level fixed-effects model, the effect of public reporting on financial performance was measured by comparing each of four financial outcomes (revenues, expenses, operating, and total profit margins) before (1999–2002) to after (2003–2005) public reporting was initiated. The effects were estimated separately by level of performance and improvement over time.

Principal Findings. Facilities that improved on publicly reported performance had increased revenues and higher profit margins after public reporting, mainly through increased Medicare admissions. High-scoring facilities showed similar patterns, though differences were not statistically significant.

Conclusions. Providers that improve their performance under public reporting may receive a return on their investment in quality improvement. This supports the business case for public reporting.

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