메뉴 건너뛰기




Volumn 55, Issue , 2018, Pages

Assessing the quality of nursing homes in managed care organizations: Integrating LTSS for dually eligible beneficiaries

Author keywords

Dually eligible; Managed care; Medicaid; Network quality; Nursing homes; Quality indicators

Indexed keywords

ARTICLE; ATTENTION; CALIFORNIA; DECISION MAKING; HUMAN; MANAGED CARE ORGANIZATION; MEDICAID; NURSING HOME; NURSING STAFF; REGISTERED NURSE; HEALTH CARE QUALITY; HEALTH INSURANCE; MEDICARE; PERSONNEL MANAGEMENT; STATISTICS AND NUMERICAL DATA; SUPPLY AND DISTRIBUTION; UNITED STATES;

EID: 85056428849     PISSN: 00469580     EISSN: 19457243     Source Type: Journal    
DOI: 10.1177/0046958018800090     Document Type: Article
Times cited : (5)

References (49)
  • 1
    • 84962129278 scopus 로고    scopus 로고
    • Hospital-skilled nursing facility referral linkage reduces readmission rates among Medicare patients receiving major surgery
    • Schoenfeld AJ, Zhang X, Grabowski DC, Mor V, Weissman JS, Rahman M. Hospital-skilled nursing facility referral linkage reduces readmission rates among Medicare patients receiving major surgery. Surgery. 2016;159(5):1461-1468.
    • (2016) Surgery , vol.159 , Issue.5 , pp. 1461-1468
    • Schoenfeld, A.J.1    Zhang, X.2    Grabowski, D.C.3    Mor, V.4    Weissman, J.S.5    Rahman, M.6
  • 2
    • 84971430907 scopus 로고    scopus 로고
    • The contribution of skilled nursing facilities to hospitals’ readmission rates
    • Rahman M, McHugh J, Gozalo PL, Ackerly DC, Mor V. The contribution of skilled nursing facilities to hospitals’ readmission rates. Health Serv Res. 2017;52(2):656-675.
    • (2017) Health Serv Res , vol.52 , Issue.2 , pp. 656-675
    • Rahman, M.1    McHugh, J.2    Gozalo, P.L.3    Ackerly, D.C.4    Mor, V.5
  • 4
    • 85011841733 scopus 로고    scopus 로고
    • ACO-affiliated hospitals reduced rehospitalizations from skilled nursing facilities faster than other hospitals
    • Winblad U, Mor V, McHugh JP, Rahman M. ACO-affiliated hospitals reduced rehospitalizations from skilled nursing facilities faster than other hospitals. Health Aff (Millwood). 2017;36(1):67-73.
    • (2017) Health Aff (Millwood) , vol.36 , Issue.1 , pp. 67-73
    • Winblad, U.1    Mor, V.2    McHugh, J.P.3    Rahman, M.4
  • 5
    • 84978306073 scopus 로고    scopus 로고
    • Accountability across the continuum: The participation of postacute care providers in accountable care organizations
    • Colla CH, Lewis VA, Bergquist SL, Shortell SM. Accountability across the continuum: the participation of postacute care providers in accountable care organizations. Health Aff (Millwood). 2016;51(4):1595-1611.
    • (2016) Health Aff (Millwood) , vol.51 , Issue.4 , pp. 1595-1611
    • Colla, C.H.1    Lewis, V.A.2    Bergquist, S.L.3    Shortell, S.M.4
  • 6
    • 34548675186 scopus 로고    scopus 로고
    • Determinants of remaining in the community after discharge: Results from New Jersey’s nursing home transition program
    • Howell S, Silberberg M, Quinn WV, Lucas JA. Determinants of remaining in the community after discharge: results from New Jersey’s nursing home transition program. Gerontologist. 2007;47(4):535-547.
    • (2007) Gerontologist , vol.47 , Issue.4 , pp. 535-547
    • Howell, S.1    Silberberg, M.2    Quinn, W.V.3    Lucas, J.A.4
  • 7
    • 84862489054 scopus 로고    scopus 로고
    • Among dual eligible, identifying the highest-cost individuals could help in crafting more targeted and effective response
    • Coughlin RA, Waldmann TA, Phadera L. Among dual eligible, identifying the highest-cost individuals could help in crafting more targeted and effective response. Health Aff (Millwood). 2012;31(5):1083-1091.
    • (2012) Health Aff (Millwood) , vol.31 , Issue.5 , pp. 1083-1091
    • Coughlin, R.A.1    Waldmann, T.A.2    Phadera, L.3
  • 8
    • 85003055616 scopus 로고    scopus 로고
    • Effect of long-term care use on Medicare and Medicaid expenditures for dual eligible and non-dual eligible elderly beneficiaries
    • Kane RL, Wysocki A, Parashuram S, Shippee T, Lum T. Effect of long-term care use on Medicare and Medicaid expenditures for dual eligible and non-dual eligible elderly beneficiaries. Medicare Medicaid Res Rev. 2013;3(3). doi:10.5600/mmrr.003.03.a05.
    • (2013) Medicare Medicaid Res Rev , vol.3 , Issue.3
    • Kane, R.L.1    Wysocki, A.2    Parashuram, S.3    Shippee, T.4    Lum, T.5
  • 9
    • 84892771537 scopus 로고    scopus 로고
    • Medicare-Medicaid eligible beneficiaries and potentially avoidable hospitalizations
    • Segal M, Rollins E., Hodges K, Roozeboom M. Medicare-Medicaid eligible beneficiaries and potentially avoidable hospitalizations. Medicare Medicaid Res Rev. 2014:4(1). doi:10.5600/mmrr.004.01.b01.
    • (2014) Medicare Medicaid Res Rev , vol.4 , Issue.1
    • Segal, M.1    Rollins, E.2    Hodges, K.3    Roozeboom, M.4
  • 10
    • 84921843060 scopus 로고    scopus 로고
    • Higher Medicare SNF care utilization by dual-eligible beneficiaries: Can Medicaid long-term care policies be the answer?
    • Rahman M, Typer D, Thomas KS, Grabowski DC, Mor V. Higher Medicare SNF care utilization by dual-eligible beneficiaries: can Medicaid long-term care policies be the answer? Health Serv Res. 2015;50(1):161-179.
    • (2015) Health Serv Res , vol.50 , Issue.1 , pp. 161-179
    • Rahman, M.1    Typer, D.2    Thomas, K.S.3    Grabowski, D.C.4    Mor, V.5
  • 11
    • 84903825221 scopus 로고    scopus 로고
    • Dual eligibility, selection of skilled nursing facility, and length of Medicare paid post acute stay
    • Rahman M, Gozalo P, Tyler D, Grabowski DC, Trivedi A, Mor V. Dual eligibility, selection of skilled nursing facility, and length of Medicare paid post acute stay. Med Care Res Rev. 2014;7(4):384-401.
    • (2014) Med Care Res Rev , vol.7 , Issue.4 , pp. 384-401
    • Rahman, M.1    Gozalo, P.2    Tyler, D.3    Grabowski, D.C.4    Trivedi, A.5    Mor, V.6
  • 12
    • 59449096847 scopus 로고    scopus 로고
    • Special needs plans and the coordination of benefits and services for dual eligible
    • Grabowski DC. Special needs plans and the coordination of benefits and services for dual eligible. Health Aff (Millwood). 2009;28(1):136-146.
    • (2009) Health Aff (Millwood) , vol.28 , Issue.1 , pp. 136-146
    • Grabowski, D.C.1
  • 14
    • 85065613439 scopus 로고    scopus 로고
    • Sacramento, CA. Date unknown, Accessed October 25, 2017
    • California Department of Health Care Services. Dual Eligibles Coordinated Care Demonstration—Cal MediConnect. Sacramento, CA. Date unknown. http://www.dhcs.ca.gov/Pages/DualsDemonstration.aspx. Accessed October 25, 2017.
    • Dual Eligibles Coordinated Care Demonstration—Cal Mediconnect
  • 15
    • 85065611610 scopus 로고    scopus 로고
    • Published 2017. Accessed October 1
    • California Department of Health Care Services. Cal MediConnect Monthly Enrollment Dashboard. http://caldu-als.org/wp-content/uploads/2017/09/August-2017-CMC-Enrollment-Dashboard.pdf. Published 2017. Accessed October 1, 2017.
    • (2017) Cal Mediconnect Monthly Enrollment Dashboard
  • 16
    • 85050732818 scopus 로고    scopus 로고
    • The Chronic Care Act of 2018: Advancing Care for Adults With Complex Needs
    • Published March, Accessed August 28, 2018
    • Tumlinson A, Burke M, Alkema G. The Chronic Care Act of 2018: Advancing Care for Adults With Complex Needs. The SCAN Foundation. http://www.thescanfoundation.org/chronic-care-act-2018-advancing-care-adults-complex-needs. Published March 2018. Accessed August 28, 2018.
    • (2018) The SCAN Foundation
    • Tumlinson, A.1    Burke, M.2    Alkema, G.3
  • 17
    • 84995704303 scopus 로고    scopus 로고
    • Differences in nursing home quality between Medicare advantage and traditional Medicare patients
    • Chang E, Ruder T, Setodji C, et al. Differences in nursing home quality between Medicare advantage and traditional Medicare patients. J Am Med Dir Assoc. 2016;17(10):960.e9-960.e14.
    • (2016) J am Med Dir Assoc , vol.17 , Issue.10 , pp. e9-960
    • Chang, E.1    Ruder, T.2    Setodji, C.3
  • 18
    • 84901009688 scopus 로고    scopus 로고
    • Are duel eligible admitted to poorer quality skilled nursing facilities?
    • Rahman M, Grabowski DC, Gozalo PL, Thomas KS, Mor V. Are duel eligible admitted to poorer quality skilled nursing facilities? Health Serv Res. 2014;49(3):798-817.
    • (2014) Health Serv Res , vol.49 , Issue.3 , pp. 798-817
    • Rahman, M.1    Grabowski, D.C.2    Gozalo, P.L.3    Thomas, K.S.4    Mor, V.5
  • 19
    • 85046819800 scopus 로고    scopus 로고
    • Medicare advantage enrollees more likely to enter lower-quality nursing homes compared to fee-for-service enrollees
    • Meyers DJ, Mor V, Rahman M. Medicare advantage enrollees more likely to enter lower-quality nursing homes compared to fee-for-service enrollees. Health Aff (Millbank). 2018;37(1): 78-85.
    • (2018) Health Aff (Millbank) , vol.37 , Issue.1 , pp. 78-85
    • Meyers, D.J.1    Mor, V.2    Rahman, M.3
  • 20
    • 77949712445 scopus 로고    scopus 로고
    • Published 2015. Accessed August 28, 2018
    • Centers for Medicare & Medicaid Services (CMS). Nursing Home Compare. http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1. Published 2015. Accessed August 28, 2018.
    • Nursing Home Compare
  • 21
    • 85065624922 scopus 로고    scopus 로고
    • Published May. 2017. Accessed August 28
    • University of California San Francisco. Cal Quality Care Website Data. www.Calqualitycare.org. Published May. 2017. Accessed August 28, 2018.
    • (2018) Cal Quality Care Website Data
  • 22
    • 81755172008 scopus 로고    scopus 로고
    • Does information matter? Competition, quality, and the impact of nursing home report cards
    • Grabowski DC, Town RJ. Does information matter? competition, quality, and the impact of nursing home report cards. Health Serv Res. 2011;46(6):1698-1719.
    • (2011) Health Serv Res , vol.46 , Issue.6 , pp. 1698-1719
    • Grabowski, D.C.1    Town, R.J.2
  • 24
    • 62449101302 scopus 로고    scopus 로고
    • Impact of public reporting on unreported quality of care
    • Werner RM, Konetzka RT, Kruse GB. Impact of public reporting on unreported quality of care. Health Serv Res. 2009;44(2, pt 1):379-398.
    • (2009) Health Serv Res , vol.44 , Issue.2 , pp. 379-398
    • Werner, R.M.1    Konetzka, R.T.2    Kruse, G.B.3
  • 25
    • 84996848734 scopus 로고    scopus 로고
    • Personalizing nursing home compare and the discharge from hospitals to nursing homes
    • Mukamel DB, Amin A, Weimer DL, et al. Personalizing nursing home compare and the discharge from hospitals to nursing homes. Health Serv Res. 2016;51(4):2076-2094.
    • (2016) Health Serv Res , vol.51 , Issue.4 , pp. 2076-2094
    • Mukamel, D.B.1    Amin, A.2    Weimer, D.L.3
  • 26
    • 84958261016 scopus 로고    scopus 로고
    • Changes in consumer demand following public reporting of summary quality ratings: An evaluation in nursing homes
    • Werner RM, Knoetzka RT, Polsky D. Changes in consumer demand following public reporting of summary quality ratings: an evaluation in nursing homes. Health Serv Res. 2016;51(suple 2):1291-1309.
    • (2016) Health Serv Res , vol.51 , pp. 1291-1309
    • Werner, R.M.1    Knoetzka, R.T.2    Polsky, D.3
  • 27
    • 85027106027 scopus 로고    scopus 로고
    • Patients are not given quality-of-care data about skilled nursing facilities when discharged from hospitals
    • Tyler DA, Gadbois EA, McHugh JP, Shield RR, Winblad U, Mor V. Patients are not given quality-of-care data about skilled nursing facilities when discharged from hospitals. Health Aff (Millwood). 2017;26(8):1385-1391.
    • (2017) Health Aff (Millwood) , vol.26 , Issue.8 , pp. 1385-1391
    • Tyler, D.A.1    Gadbois, E.A.2    McHugh, J.P.3    Shield, R.R.4    Winblad, U.5    Mor, V.6
  • 28
    • 84928378344 scopus 로고    scopus 로고
    • Creating a network of high-quality skilled nursing facilities: Preliminary data on the postacute care quality improvement experiences of an accountable care organization
    • Lage DE, Rusinak D, Carr D, Grabowski DC, Ackerly DC. Creating a network of high-quality skilled nursing facilities: preliminary data on the postacute care quality improvement experiences of an accountable care organization. J Am Geriatr Soc. 2015;63(4):804-808.
    • (2015) J am Geriatr Soc , vol.63 , Issue.4 , pp. 804-808
    • Lage, D.E.1    Rusinak, D.2    Carr, D.3    Grabowski, D.C.4    Ackerly, D.C.5
  • 30
    • 85065609384 scopus 로고    scopus 로고
    • Published, Accessed August 28, 2018
    • The Scan Foundation. Evaluating Medicare-Medicaid integration. http://www.thescanfoundation.org/evaluating-medicare-medic-aid-integration. Published 2018. Accessed August 28, 2018.
    • (2018) Evaluating Medicare-Medicaid Integration
  • 33
    • 85065627521 scopus 로고    scopus 로고
    • Published 2017. Accessed July 15, 2017
    • Centers for Medicare & Medicaid Services (CMS). Nursing Home Compare Data Archives. https://data.medicare.gov/data/archives/nursing-home-compare. Published 2017. Accessed July 15, 2017.
    • Nursing Home Compare Data Archives
  • 34
    • 85065606361 scopus 로고    scopus 로고
    • Accessed October 25
    • University of California San Francisco. CalQualityCare Ratings and Guidelines. Date unknown. http://www.calqualitycare.org/ratings-data-sources/nursing-homes/. Accessed October 25, 2017.
    • (2017) Calqualitycare Ratings and Guidelines
  • 35
    • 79957441927 scopus 로고    scopus 로고
    • Caregiver staffing in nursing homes and their influence on quality of care: Using dynamic panel estimation methods
    • Castle NG, Anderson RA. Caregiver staffing in nursing homes and their influence on quality of care: using dynamic panel estimation methods. Med Care. 2011;49(6):545-552.
    • (2011) Med Care , vol.49 , Issue.6 , pp. 545-552
    • Castle, N.G.1    Anderson, R.A.2
  • 37
    • 85042370744 scopus 로고    scopus 로고
    • Analyses of complaints, investigations of allegations and deficiency citations in United States nursing homes
    • published online ahead of print December 12
    • Hansen KE, Hyer K, Holup AA, Smith KM, Small BJ. Analyses of complaints, investigations of allegations and deficiency citations in United States nursing homes [published online ahead of print December 12, 2017]. Med Care Res Rev. doi:10.1177/1077558717744863.
    • (2017) Med Care Res Rev
    • Hansen, K.E.1    Hyer, K.2    Holup, A.A.3    Smith, K.M.4    Small, B.J.5
  • 38
    • 3342903495 scopus 로고    scopus 로고
    • Driven to tiers: Socioeconomic and racial disparities in the quality of nursing home care
    • Mor V, Zinn J, Angelelli J, Teno JM, Miller SC. Driven to tiers: socioeconomic and racial disparities in the quality of nursing home care. Milbank Q. 2004;82(2):227-256.
    • (2004) Milbank Q , vol.82 , Issue.2 , pp. 227-256
    • Mor, V.1    Zinn, J.2    Angelelli, J.3    Teno, J.M.4    Miller, S.C.5
  • 39
  • 41
    • 85021795675 scopus 로고    scopus 로고
    • Published April 27, 2016. Accessed August 28, 2018
    • Centers for Medicare & Medicaid Services (CMS). New Quality Measures on Nursing Home Compare. https://www. cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-04-27.html. Published April 27, 2016. Accessed August 28, 2018.
    • New Quality Measures on Nursing Home Compare
  • 43
    • 85065627497 scopus 로고    scopus 로고
    • Medicare Special Needs Plans. Date unknown
    • Accessed April 11
    • Centers for Medicare & Medicaid Services (CMS). Medicare Special Needs Plans. Date unknown. https://www.medicare. gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/special-needs-plans.html. Accessed April 11, 2018.
    • (2018) Centers for Medicare & Medicaid Services (CMS)
  • 45
    • 0034107280 scopus 로고    scopus 로고
    • Experts recommend minimum nurse staffing standards for nursing facilities in the United States
    • Harrington C, Kovner C, Kayser-Jones J, et al. Experts recommend minimum nurse staffing standards for nursing facilities in the United States. Gerontologist. 2000;40(1):1-12.
    • (2000) Gerontologist , vol.40 , Issue.1 , pp. 1-12
    • Harrington, C.1    Kovner, C.2    Kayser-Jones, J.3
  • 46
    • 85065603059 scopus 로고    scopus 로고
    • Nursing staffing requirements to meet the demands of today’s long term care consumer recommendations from the Coalition of Geriatric Nursing Organizations (CGNO)
    • Published November 12, 2014. Accessed August 28
    • American Nurses Association. Nursing staffing requirements to meet the demands of today’s long term care consumer recommendations from the Coalition of Geriatric Nursing Organizations (CGNO). Position Statement. www.nursing-world.org.Published November 12, 2014. Accessed August 28, 2018.
    • (2018) Position Statement
  • 47
    • 84992598506 scopus 로고    scopus 로고
    • Determining nurse aide staffing requirements to provide care based on resident workload: A discrete event simulation model
    • Schnelle J, Schroyer LD, Saraf AV, Simmons SF. Determining nurse aide staffing requirements to provide care based on resident workload: a discrete event simulation model. J Am Med Dir Assoc. 2016;17:970-977.
    • (2016) J am Med Dir Assoc , vol.17 , pp. 970-977
    • Schnelle, J.1    Schroyer, L.D.2    Saraf, A.V.3    Simmons, S.F.4
  • 48
    • 84988949616 scopus 로고    scopus 로고
    • The effect of narrow provider networks on health care use
    • Atwood A, Lo Sasso AT. The effect of narrow provider networks on health care use. J. Health Econ. 2016;50:86-98.
    • (2016) J. Health Econ. , vol.50 , pp. 86-98
    • Atwood, A.1    Lo Sasso, A.T.2
  • 49
    • 84994246585 scopus 로고    scopus 로고
    • Marketplace plans with narrow physician networks feature lower monthly premiums than plans with larger networks
    • Polsky D, Cidav Z, Swanson A. Marketplace plans with narrow physician networks feature lower monthly premiums than plans with larger networks. Health Aff (Millwood). 2016;35(10):1842-1848.
    • (2016) Health Aff (Millwood) , vol.35 , Issue.10 , pp. 1842-1848
    • Polsky, D.1    Cidav, Z.2    Swanson, A.3


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.