Unbiased Analysis of Today's Healthcare Issues

The Effect of Medicaid P4P on Nursing Home Quality

Over 10 million Americans need long-term services and supports to assist them in life’s daily activities.  Of these, 1.6 million reside in a nursing home. Nursing home care, however, is expensive ($74,800 per year) and and quality is highly variable. To improve the quality of care, many states have begun adopting pay-for-performance (P4P) programs for nursing homes. Between […]

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Effect of Nursing Home Ownership on Quality

Do non-profit nursing home provide better quality than for-profit nursing homes? Generally, for-profit nursing homes appear to have better quality measures, but this could be due to the fact that non-profit nursing homes act as a safety net, whereas non-profit nursing homes treat sicker patients. Today, I look at Grabowski et al. (2012)‘s attempt to […]

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Nursing Home Quality

Typically, Nursing Home quality is measured using metrics from Nursing Home Compare. These metrics are calculated based on survey and certification processes and resident assessments from from the Minimum Data Set (MDS). These, however, are not the only quality metrics one can use. For instance, one can use consumer complaints as a measure of quality […]

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Does Public Reporting Affect Patient Behavior?

A number of studies have already examined this question. Baker et al. (2003) examined the effectiveness of a public reporting effort in hospitals in Ohio, finding little relationship between a hospital’s report card ranking and changes in its market share. Cutler et al. (2004) examined the effects of reporting quality information about cardiac surgery on […]

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CLASS Act Repealed

In 2011, 13 percent of Americans were over 65 years old.  In the coming years, this number will only increase.  Unsurprisingly, the demand for long-term care will also increase. Currently, spending on long-term care in Medicaid only was over $50 billion in 2009. One option for increasing the affordability of the long-term care market is […]

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Maximizing utility for end-of-life care

Hospitals in Sacramento were concerned about the large number of nusring home transfers to its facility.  Were many of these tranfers unnecessary? Did patients with little chance of recovery benefit from these hospital stays? To reduce end-of-life tranfers to hospitals from nursing homes, 3 Sacramento-area hospital systems and 18 nursing homes instuted the Preparing Residents […]

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Medicaid and Long-Term Care Services

The increased use of long-term care (LTC) services has been one of the forces increasing health care cost and utilization.  Currently, 10.3 million Americans use LTC services.  The Kaiser Family Foundation provides a summary of LTC Services and Supports in the U.S. Who uses LTC? One can divide LTC services into those who receive care […]

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Should there be a mandated nurse/patient ratio in Nursing Home facilities?

A recent paper by Kitchener et al. (HSR 2008) investigates the actions of one nursing home chain to find how they maximized their profits. The authors find that Sun Healthcare Inc. employed three strategies to maximize shareholder value: rapid growth through debt-financed mergers; labor cost constraint through low nurse staffing levels; and a model of […]

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