Performing well on nursing home report cards: does it pay off?

Health Serv Res. 2011 Apr;46(2):531-54. doi: 10.1111/j.1475-6773.2010.01197.x. Epub 2010 Oct 28.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Financial Management / economics
  • Financial Management / standards
  • Medicaid / standards
  • Medicare / standards
  • Nursing Homes / economics
  • Nursing Homes / standards*
  • Quality Improvement / standards
  • Quality Indicators, Health Care / standards
  • Quality of Health Care / standards
  • United States