Duke 2008 | ASHE | Equity and Efficiency in Health and Healthcare

This invited session will merge cutting-edge research with a policy discussion. The topic is how Nursing Home Compare, a web-based source for nursing home “report cards”, affects quality of care. The Centers for Medicare and Medicaid Services (CMS) require nursing homes to report certain quality measures to the public. Like all information in a competitive environment, report cards have the potential to improve quality competition, either by steering informed consumers to higher quality nursing homes, or by spurring nursing homes to improve their quality. Because this regulation is relatively new, the academic literature on whether it is effective in reaching this goal is just starting to emerge.

This session will begin with an overview of the current literature on nursing home quality of care. Prof. David Grabowski (Harvard) will summarize what is known about the factors that affect nursing home quality of care. Having this summary will place the featured research paper and following policy discussion in context. Then Prof. Rachel Werner (U Pennsylvania) will present recent findings on how nursing home report cards affect quality of care. Her study combines longitudinal data on a nationally-representative sample of nursing homes with detailed clinical information at the resident level. The unique format of this session will allow Werner more time than usual to present her results.

Next, two well-known economists with strong policy ties will comment on the paper and the field. Dr. Gail Wilensky (Project Hope) is well known as an expert in health policy with both strong academic and policy credentials. (We have invited another person with a similarly strong background to be the second discussant, but do not yet have confirmation.) Having the two policy discussants makes this session unique. The discussants will be able to comment both on the technical aspects of the research, but also give their perspective on what policymakers care about and can control.