The effect of pay-for-performance in nursing homes: Evidence from state medicaid programs

Health Services Research

Volumn 48, Issue 4, 2013, Pages 1393-1414

  Werner, Rachel M ^a   Konetzka, R Tamara ^b   Polsky, Daniel ^c  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

^b UNIVERSITY OF CHICAGO   (United States)

^c UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

long term care; nursing home quality; pay for performance; Quality of care

Indexed keywords

ARTICLE; CONTROLLED STUDY; DECUBITUS; DISEASE SEVERITY; HEALTH CARE PLANNING; HEALTH CARE QUALITY; HEALTH PROGRAM; HUMAN; IMMOBILIZATION; MEDICAID; MEDICAL FEE; NURSING HOME; NURSING HOME PATIENT; NURSING STAFF; PAIN; REIMBURSEMENT; UNITED STATES;

LONG-TERM CARE; NURSING HOME QUALITY; PAY-FOR-PERFORMANCE; QUALITY OF CARE;

AGED, 80 AND OVER; FEMALE; HEALTH CARE SURVEYS; HUMANS; MALE; MEDICAID; NURSING HOMES; QUALITY IMPROVEMENT; QUALITY INDICATORS, HEALTH CARE; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE; UNITED STATES;

EID: 84879839568     PISSN: 00179124     EISSN: 14756773     Source Type: Journal    
DOI: 10.1111/1475-6773.12035     Document Type: Article

References (38)

1. Abt Associates Inc. 2001. Report to Congress: Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes Phase II Final Report. Baltimore, MD: Centers for Medicare and Medicaid Services.
2. Abt Associates Inc. 2006. Quality Monitoring for Medicare Global Payment Demonstrations: Nursing Home Quality-Based Purchasing Demonstration. Baltimore, MD: Centers for Medicare and Medicaid Services.
3. Berlowitz, D. R., G. H. Brandeis, J. J. Anderson, A. S. Ash, B. Kader, J. N. Morris, and, M. A. Moskowitz,. 2001. " Evaluation of a Risk-Adjustment Model for Pressure Ulcer Development Using the Minimum Data Set." Journal of the American Geriatrics Society 49 (7): 872-6.
4. Castle, N. G., B. S. Fogel, and, V. Mor,. 1996. " Study Shows Higher Quality of Care in Facilities Administered by ACHCA Members." Journal of Long Term Care Administration 24 (2): 11-6.
5. Centers for Medicare and Medicaid. 2005. " Medicare Begins Performance-Based Payments for Physicians Groups: New Demonstration Program Tests Financial Incentives for Improved Quality and Coordination in Large Group Practices " [accessed January 16, 2008]. Available at http://www.cms.hhs. gov/apps/media/press/release.asp?Counter=1341
6. Centers for Medicare and Medicaid. 2007. " Medicare Announces Plans for Home Health Pay for Performance Demonstration " [accessed on September 12, 2008]. Available at http://www.cms.hhs.gov/apps/media/press-releases.asp
7. Centers for Medicare and Medicaid Services. 2003. " Premier Hospital Quality Incentive Demonstration " [accessed January 16, 2008]. Available at http://www.cms.hhs.gov/HospitalQualityInits/35-HospitalPremier.asp
8. Fries, B. E., C. Hawes, J. N. Morris, C. D. Phillips, V. Mor, and, P. S. Park,. 1997. " Effect of the National Resident Assessment Instrument on Selected Health Conditions and Problems." Journal of the American Geriatrics Society 45 (8): 994-1001.
9. Huber, P. J., 1967. " The Behavior of Maximum Likelihood Estimates under Non-Standard Conditions."In Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability, edited by, L. M. Le Cam, and, J. Neyman, pp. 221-33. Berkeley, CA: University of California Press.
10. Institute of Medicine. 1986. Improving the Quality of Care in Nursing Homes. Washington, DC: National Academies Press.
11. Kaiser Family Foundation. 2007. " Medicaid and Long-Term Care Services and Supports " [accessed August 20, 2008]. Available at http://www.kff.org/medicaid/upload/2186-05.pdf
12. Kane, R. L., G. Arling, C. Mueller, R. Held, and, V. Cooke,. 2007. " A Quality-Based Payment Strategy for Nursing Home Care in Minnesota." The Gerontologist 47 (1): 108-15.
13. Kane, R. L., C. C. Williams, T. F. Williams, and, R. A. Kane,. 1993. " Restraining Restraints: Changes in a Standard of Care." Annual Review of Public Health 14: 545-84.
14. Kidder, D., M. Rennison, H. Goldberg, D. Warner, B. Bell, L. Hadden, J. Morris, R. Jones, and, V. Mor, (2002). MegaQI Covariate Analysis and Recommendations: Identification and Evaluation of Existing Quality Indicators that are Appropriate for Use in Long-Term Care Settings. Contract No. 500-95-0062 TO #4, Abt Associates Inc.
15. Kirby, K., 1997. " Bidding on the Future: Evidence against Normative Discounting of Delayed Rewards." Journal of Experimental Psychology: General 126: 54-70.
16. Li, Y., X. Cai, L. G. Glance, W. D. Spector, and, D. B. Mukamel,. 2009. " National Release of the Nursing Home Quality Report Cards: Implications of Statistical Methodology for Risk Adjustment." Health Services Research 44 (1): 79-102.
17. Minnesota Department of Human Services. 2007. " Minnesota Quality Indicators and Adjusters-Detailed " [accessed December 14, 2011]. Available at http://www.dhs.state.mn.us/main/groups/aging/documents/pub/dhs-id-051942.pdf
18. Mor, V., O. Intrator, B. E. Fries, C. Phillips, J. Teno, J. Hiris, C. Hawes, and, J. Morris., 1997. " Changes in Hospitalization Associated with Introducing the Resident Assessment Instrument." Journal of the American Geriatrics Society 45 (8): 1002-10.
19. Mor, V., J. Zinn, J. Angelelli, J. M. Teno, and, S. C. Miller,. 2004. " Driven to Tiers: Socioeconomic and Racial Disparities in the Quality of Nursing Home Care." Milbank Quarterly 82 (2): 227-56.
20. Morris, J. N., B. E. Fries, D. R. Mehr, C. Hawes, C. Phillips, V. Mor, and, L. A. Lipsitz., 1994. " MDS Cognitive Performance Scale." Journal of Gerontology 49 (4): M174-82.
21. Morris, J. N., B. E. Fries, and, S. A. Morris,. 1999. " Scaling ADLs within the MDS." Journals of Gerontology Series A: Biological Sciences and Medical Sciences 54 (11): M546-53.
22. Morris, J. N., T. Moore, R. Jones, V. Mor, J. Angelelli, K. Berg, C. Hale, S. Morris, K. M. Murphy, and, M. Rennison,. 2003. Validation of Long-Term and Post-Acute Care Quality Indicators. Baltimore, MD: Centers for Medicare and Medicaid Services.
23. Mukamel, D. B., L. G. Glance, Y. Li, D. L. Weimer, W. D. Spector, J. S. Zinn, and, L. Mosqueda., 2008. " Does Risk Adjustment of the CMS Quality Measures for Nursing Homes Matter? " Medical Care 46 (5): 532-41.
24. Norton, E. C., 1992. " Incentive Regulation of Nursing Homes." Journal of Health Economics 11 (2): 105-28.
25. Nursing Home Quality Initiative. 2004. Quality Measures Resource Manual: Enhanced Set of Quality Measures. Baltimore, MD: Centers for Medicare and Medicaid Services.
26. Park, J., and, R. M. Werner,. 2011. " Changes in the Relationship between Nursing Home Financial Performance and Quality of Care under Public Reporting." Health Economics 20: 783-801.
27. Petersen, L. A., L. D. Woodard, T. Urech, C. Daw, and, S. Sookanan., 2006. " Does Pay-for-Performance Improve the Quality of Health Care? " Annals of Internal Medicine 145 (4): 265-72.
28. Robinson, J. C., 2001. " Theory and Practice in the Design of Physician Payment Incentives." Milbank Quarterly 79 (2): 149-77.
29. Rosenthal, M. B., and, R. A. Dudley,. 2007. " Pay-for-Performance: Will the Latest Payment Trend Improve Care? " Journal of the American Medical Association 297 (7): 740-4.
30. Rosenthal, M. B., and, R. G. Frank,. 2006. " What is the Empirical Basis for Paying for Quality in Health Care? " Medical Care Research and Review 63 (2): 135-57.
31. Rosenthal, M. B., B. E. Landon, S.-L. T. Normand, R. G. Frank, and, A. M. Epstein., 2006. " Pay for Performance in Commercial HMOs." New England Journal of Medicine 355 (18): 1895-902.
32. Shorr, R. I., R. L. Fought, and, W. A. Ray., 1994. " Changes in Antipsychotic Drug Use in Nursing Homes during Implementation of the OBRA-87 Regulations." Journal of the American Medical Association 271 (5): 358-62.
33. Snowden, M., and, P. Roy-Byrne,. 1998. " Mental Illness and Nursing Home Reform: OBRA-87 Ten Years Later. Omnibus Budget Reconciliation Act." Psychiatric Services 49 (2): 229-33.
34. Thaler, R. H., 1981. " Some Empirical Evidence on Time Inconsistency." Review of Economic Studies 23: 165-80.
35. Werner, R. M., J. T. Kolstad, E. A. Stuart, and, D. Polsky,. 2011. " The Effect of Pay-for-Performance in Hospitals: Lessons for Quality Improvement." Health Affairs 30 (4): 690-8.
36. Werner, R. M., R. T. Konetzka, and, K. Liang,. 2010. " State Adoption of Nursing Home Pay-for-Performance." Medical Care Research and Review 67: 364-77.
37. White, H., 1980. " A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity." Econometrica 48: 817-30.
38. Wunderlich, G. S., and, P. Kohler,. 2000. Improving the Quality of Long-Term Care. Washington, DC: Division of Health Care Services, Institute of Medicine.