Does risk adjustment of the CMS quality measures for nursing homes matter?

Medical Care

Volumn 46, Issue 5, 2008, Pages 532-541

  Mukamel, Dana B ^a   Glance, Laurent G ^b   Li, Yue ^c   Weimer, David L ^d   Spector, William D ^e   Zinn, Jacqueline S ^f   Mosqueda, Laura ^g  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF ROCHESTER   (United States)

^c UNIVERSITY AT BUFFALO   (United States)

^d UNIVERSITY OF WISCONSIN MADISON   (United States)

^e AGENCY FOR HEALTHCARE RESEARCH AND QUALITY   (United States)

^f TEMPLE UNIVERSITY   (United States)

^g UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Nursing home compare; Nursing homes; Quality of care; Quality report cards; Risk adjusted outcome measures of quality

Indexed keywords

AGE DISTRIBUTION; AGED; ALGORITHM; ARTICLE; COMPARATIVE STUDY; DECUBITUS; EXERCISE; GOVERNMENT; HEALTH CARE QUALITY; HUMAN; LENGTH OF STAY; MIDDLE AGED; NURSING HOME; PAIN; RETROSPECTIVE STUDY; RISK ASSESSMENT; RISK FACTOR; STANDARD; STATISTICAL MODEL; UNITED STATES;

AGE DISTRIBUTION; AGED; AGED, 80 AND OVER; ALGORITHMS; CENTERS FOR MEDICARE AND MEDICAID SERVICES (U.S.); HUMANS; LENGTH OF STAY; LOGISTIC MODELS; MIDDLE AGED; NURSING HOMES; PAIN; PRESSURE ULCER; QUALITY INDICATORS, HEALTH CARE; RESTRAINT, PHYSICAL; RETROSPECTIVE STUDIES; RISK ADJUSTMENT; RISK FACTORS; UNITED STATES;

EID: 42549128685     PISSN: 00257079     EISSN: None     Source Type: Journal    
DOI: 10.1097/MLR.0b013e31816099c5     Document Type: Article

References (49)

1. Mor V. Improving the quality of long-term care with better information. Milbank Quarterly. 2005;83:333-364.
2. Winzelberg GS. The quest for nursing home quality: learning history's lessons. Arch Intern Med. 2003;163:2552-2556.
3. Mukamel DB, Spector WD. Quality report cards and nursing home quality. Gerontologist. 2003;43(special issue 2):58-66.
4. Centers for Medicare & Medicaid Services. Nursing Home Quality Initiatives. webpage]. 12/1/06; General Information. Available at: http://www.cms.hhs.gov/QualityInitiativesGenInfo/. Accessed December 1, 2006.
5. Harrington C, Collier E, O'Meara J, et al. Federal and state nursing facility websites: just what the consumer needs? Am J Med Qual. 2003;18:21-37.
6. Berlowitz DR, Rosen A, Wang F, et al. Purchasing or providing nursing home care: can quality data provide guidance. J Am Geriatr Soc. 2005;53:603-608.
7. Centers for Medicare & Medicaid Services. Nursing Home Quality Initiative Overview (Updated 1/20/04). Available at: http://www.cms.hhs.gov/ NursingHomeQualityInits/downloads/NHQIOverview.pdf. Accessed August 30, 2007.
8. Iezzoni LI. Risk Adjustment for Measuring Health Care Outcomes. Ann Arbor, MI: Health Administration Press; 1994.
9. Iezzoni LI, Ash AS, Shwartz M, et al. Judging Hospitals by severity-adjusted mortality rates: the influence of the severity-adjustment method. Am J Public Health. 1996;86:1379.
10. Glance LG, Osler TM, Dick AW. Evaluating trauma center quality: does the choice of the severity-adjustment model make a difference? J Trauma. 2005;58:1265-1271.
11. Glance LG, Osler TM, Dick A. Rating the quality of intensive care units: is it a function of the intensive care unit scoring system? Crit Care Med. 2002;30:1976-1982.
12. Mukamel DB, Brower CA. The influence of risk adjustment methods on conclusions about quality of care in nursing homes based on outcome measures. Gerontologist. 1998;38:695-703.
13. Berlowitz DR, Ash AS, Brandeis GH, et al. Rating long-term care facilities on pressure ulcer development: importance of case-mix adjustment. Ann Intern Med. 1996;124:557-563.
14. Rosen A, Wu J, Chang BH, et al. Risk adjustment for measuring health outcomes: an application in VA long-term care. Am J Med Qual. 2001;16:118-127.
15. Mor V. Defining and measuring quality outcomes in long-term care. J Am Med Dir Assoc. 2007;8(3 Suppl 2):e129-e137.
16. Mukamel DB, Dick A, Spector WD. Specification issues in measurement of quality of medical care using risk adjusted outcomes. J Econ Soc Meas. 2000;26:267-281.
17. Li Y, Dick A, Glance LG, et al. Misspecification issues in risk adjustment and construction of outcome-based quality indicators: State University of New York at Buffalo; 2006:28.
18. Arling G, Lewis T, Kane RL, et al. Improving quality assessment through multilevel modeling: the case of nursing home compare. Health Serv Res. 2007;42:1177-1199.
19. Jha AK, Epstein AM. The predictive accuracy of the New York State coronary artery bypass surgery report-card system. Health Affairs (Millwood). 2006;25:844-855.
20. Zimmerman D. Resident based outcome measures: their potential in nursing home quality improvement [abstract]. AHSR & FHSR Annual Meeting Abstract Book. 11:57X. 1997.
21. Zimmerman DR, Karon SL, Arling G, et al. Development and testing of nursing home quality indicators. Health Care Financ Rev. 1995;16:107.
22. Morris JN, Moore T, Jones R, et al. Validation of Long-Term and Post-Acute Care Quality Indicators. Cambridge MA: Abt Associates Inc.; June 10, 2003. CMS Contract No: 500-95-0062/T.O.#4.
23. Berg K, Fries BE, Jones R, et al. Identification and Evaluation of Existing Quality Indicators that are Appropriate for Use in Long-Term Care Settings: Cambridge MA: Abt Associates Inc.; October 1, 2001. CMS Contract No: 500-95-0062/T.O.#4.
24. National Quality Forum. National voluntary consensus standards for nursing home care: A consensus report. Vol NQFCR-06-04: Washington DC; 2004.
25. Harris Y, Clauser SB. Achieving improvement through nursing home quality measurement. Health Care Financ Rev. 2002;23:5-18.
26. Hawes C, Morris JN, Phillips CD, et al. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist. 1995;35:172.
27. Mor V, Angelelli J, Jones R, et al. Inter-rater reliability of nursing home quality indicators in the U.S. BMC Health Serv Res 2003;3:20.
28. Morris JN, Hawes C, Fries BE, et al. Designing the national resident assessment instrument for nursing homes. Gerontologist. 1990;30:293.
29. Abt Associates Inc. National Nursing Home Quality Measures: User's Manual, November, 2004 (v1. 2). Cambridge, MA: U.S. Department of Health & Human Services, Center for Medicare & Medicaid Services; 2004.
30. Hosmer DW, Lemeshow S. Applied Logistic Regression. New York, NY: John Wiley & Sons; 1989.
31. Mukamel DB, Watson NM, Meng H, et al. Development of a risk-adjusted urinary incontinence outcome measure of quality for nursing homes. Med Care. 2003;41:467-478.
32. Li Y, Dick A, Glance LG, et al. Misspecification issues in risk adjustment and construction of outcome based quality indicators. HSOR 2007;7:39-56.
33. Altman DG. Practical Statistics for Medical Research. 7th ed. Boca Raton, FL: Chapman & Hall/CRC; 1991.
34. Glance LG, Dick AW, Osler TM, et al. Accuracy of hospital report cards based on administrative data. Health Serv Res. 2006;41(4 Pt 1):1413-1437.
35. Mukamel DB. Risk adjusted outcome measures and quality of care in nursing homes. Med Care. 1997;35:367-385.
36. Berlowitz DR, Brandeis GH, Anderson JJ, et al. Evaluation of a risk-adjustment model for pressure ulcer development using the Minimum Data Set. J Am Geriatr Soc. 2001;49:872-876.
37. Berlowitz DR, Brandeis GH, Morris JN, et al. Deriving a risk-adjustment model for pressure ulcer development using the Minimum Data Set. J Am Geriatr Soc. 2001;49:866-871.
38. Harrington C, O'Meara J, Kitchener M, et al. Designing a report card for nursing facilities: what information is needed and why. Gerontologist. 2003;43(Spec No 2):47-57.
39. Centers for Medicare & Medicaid Services. Medicare "Pay for Performance (P4P)" Initiatives. http://www.cms.hhs.gov/apps/media/press/ release.asp?Counter-1343. Accessed June 20, 2007.
40. Abt Associates Inc. Nursing Home Pay-for-Performance Demonstration Draft Design. http://www3.cms.hhs.gov/DemoProjectsEvalRpts/downloads/NHP4P_Handout. pdf. Accessed June 20, 2007.
41. Pesis-Katz I, Phelps CE, Temkin-Greener H, et al. Why are nursing homes' quality report cards important? Evidence from California, Ohio, New York and Texas. Academy Health. Orlando, FL; 2007.
42. Mukamel D, Spector WD, Zinn JS, et al. Nursing homes' response to the nursing home compare report card. J Gerontol B Psychol Sci Soc Sci. 2007;62:S218-S225.
43. Mukamel D, Weimer D, Spector WD, et al. Publication of quality report cards and trends in reported quality measures in nursing homes. Health Serv Res. 2008; Jan 29 [Epub ahead of print].
44. Mukamel DB, Weimer DL, Zwanziger J, et al. Quality report cards, selection of cardiac surgeons and racial disparities: a study of the publication of the NYS Cardiac Surgery Reports. Inquiry. 2004/2005;41:435-446.
45. Mukamel D, Weimer D, Mushlin A. Interpreting market share changes as evidence for effectiveness of quality report cards. Med Care. 2007;45:1227-1232.
46. Mukamel D, Spector WD, Weimer D, et al. Did the publication of the nursing home compare report card lead to "cream skimming" by nursing homes? Academy Health. Orlando, FL; 2007.
47. Narins CR, Dozier AM, Ling FS, et al. The influence of public reporting of outcome data on medical decision making by physicians. Arch Intern Med. 2005;165:83.
48. U.S. General Accounting Office. Nursing Homes: Public Reporting of Quality Indicators Has Merit, but National Implementation is Premature. GAO-03-187. Washington, DC: U.S. General Accounting Office; 2002.
49. Institute of Medicine. Committee on Redesigning Health Performance. Washington, DC; 2007.