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Do report cards predict future quality? The case of skilled nursing facilities

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  • Cornell, Portia Y.
  • Grabowski, David C.
  • Norton, Edward C.
  • Rahman, Momotazur

Abstract

Report cards on provider performance are intended to improve consumer decision-making and address information gaps in the market for quality. However, inadequate risk adjustment of report-card measures often biases comparisons across providers. We test whether going to a skilled nursing facility (SNF) with a higher star rating leads to better quality outcomes for a patient. We exploit variation over time in the distance from a patient’s residential ZIP code to SNFs with different ratings to estimate the causal effect of admission to a higher-rated SNF on health care outcomes, including mortality. We found that patients who go to higher-rated SNFs achieved better outcomes, supporting the validity of the SNF report card ratings.

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  • Cornell, Portia Y. & Grabowski, David C. & Norton, Edward C. & Rahman, Momotazur, 2019. "Do report cards predict future quality? The case of skilled nursing facilities," Journal of Health Economics, Elsevier, vol. 66(C), pages 208-221.
    • Handle: RePEc:eee:jhecon:v:66:y:2019:i:c:p:208-221
    DOI: 10.1016/j.jhealeco.2019.05.008
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    Cited by:

    1. Hendrik Schmitz & Magdalena A. Stroka‐Wetsch, 2020. "Determinants of nursing home choice: Does reported quality matter?," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 766-777, July.
    2. Atul Gupta & Sabrina T Howell & Constantine Yannelis & Abhinav Gupta, 2024. "Owner Incentives and Performance in Healthcare: Private Equity Investment in Nursing Homes," The Review of Financial Studies, Society for Financial Studies, vol. 37(4), pages 1029-1077.
    3. Bar, M.; & Bakx, P.; & Wouterse, B.; & van Doorslaer, Eddy.;, 2022. "Estimating the health value added by nursing homes," Health, Econometrics and Data Group (HEDG) Working Papers 22/12, HEDG, c/o Department of Economics, University of York.
    4. Anell, Anders & Dietrichson, Jens & Ellegård, Lina Maria & Kjellsson, Gustav, 2022. "Well-Informed Choices? Effects of Information Interventions in Primary Care on Care Quality," Working Papers 2022:2, Lund University, Department of Economics.
    5. Cronin, Christopher J. & Evans, William N., 2022. "Nursing home quality, COVID-19 deaths, and excess mortality," Journal of Health Economics, Elsevier, vol. 82(C).
    6. Bensnes, Simon & Huitfeldt, Ingrid, 2021. "Rumor has it: How do patients respond to patient-generated physician ratings?," Journal of Health Economics, Elsevier, vol. 76(C).
    7. Templeton, Zachary S. & Apathy, Nate C. & Konetzka, R. Tamara & Skira, Meghan M. & Werner, Rachel M., 2023. "The health effects of nursing home specialization in post-acute care," Journal of Health Economics, Elsevier, vol. 92(C).
    8. Bär, Marlies & Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy, 2022. "Estimating the health value added by nursing homes," Journal of Economic Behavior & Organization, Elsevier, vol. 203(C), pages 1-23.
    9. Liran Einav & Amy Finkelstein & Neale Mahoney, 2022. "Producing Health: Measuring Value Added of Nursing Homes," NBER Working Papers 30228, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    Skilled nursing facility; Star ratings; Instrumental variables; Nursing home quality of care; Post-acute care;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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