Address correspondence to David C. Grabowski, Ph.D., Associate Professor, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899; e-mail: email@example.com. Robert J. Town, Ph.D., is with the James A. Hamilton Professor of Health Economics, Division of Health Policy and Management, University of Minnesota, Minneapolis, MN.
Does Information Matter? Competition, Quality, and the Impact of Nursing Home Report Cards
Article first published online: 25 JUL 2011
© Health Research and Educational Trust
Health Services Research
Volume 46, Issue 6pt1, pages 1698–1719, December 2011
How to Cite
Grabowski, D. C. and Town, R. J. (2011), Does Information Matter? Competition, Quality, and the Impact of Nursing Home Report Cards. Health Services Research, 46: 1698–1719. doi: 10.1111/j.1475-6773.2011.01298.x
- Issue published online: 16 NOV 2011
- Article first published online: 25 JUL 2011
- Quality of care;
- nursing homes;
- report cards;
Objective. We evaluate the effects of the Nursing Home Quality Initiative (NHQI), which introduced quality measures to the Centers for Medicare and Medicaid Services' Nursing Home Compare website, on facility performance and consumer demand for services.
Data Sources. The nursing home Minimum Data Set facility reports from 1999 to 2005 merged with facility-level data from the On-Line Survey, Certification, and Reporting System.
Study Design. We rely on the staggered rollout of the report cards across pilot and nonpilot states to examine the effect of report cards on market share and quality of care. We also exploit differences in nursing home market competition at baseline to identify the impacts of the new information on nursing home quality.
Results. The introduction of the NHQI was generally unrelated to facility quality and consumer demand. However, nursing homes facing greater competition improved their quality more than facilities in less competitive markets.
Conclusions. The lack of competition in many nursing home markets may help to explain why the NHQI report card effort had a minimal effect on nursing home quality. With the introduction of market-based reforms such as report cards, this result suggests policy makers must also consider market structure in efforts to improve nursing home performance.