On the provider side, a CMS-sponsored survey of nursing homes in the NHQI pilot states indicated that 88 percent of facilities had familiarity with Nursing Home Compare (KPMG Consulting 2003).
2005) examined trends in postacute and long-stay quality measures following the national release of the NHQI.
Moreover, the relatively short 7-month period between the NHQI pilot and the full rollout may not provide sufficient time to observe a differential response across pilot and nonpilot states.
We analyze the following five measures introduced as part of the NHQI in 2002: loss of ability in basic daily activities, infections, pressure sores (high risk), pressure sores (low risk), and physical restraints.
Thus, our analysis period stretches from well before the introduction of the NHQI report cards through their introduction and maturation.
A key source of variation in the introduction of Nursing Home Compare is the six-state NHQI pilot, which was introduced 6 1/2 months ahead of the national rollout in 2002.
Although the DD approach has the advantage of comparing outcomes across treatment and control facilities, this approach must meet the identifying assumptions that nursing homes in the pilot states are similar to nursing homes in nonpilot states, and the assumption that nursing homes in nonpilot states did not anticipate the release of these measures, especially given the 6-month period between the NHQI pilot and the full rollout.
We next estimate the following DD equation to examine the effect of the NHQI on quality of care:
The NHQI also recognizes that public information presents other market pressures to improve performance.
The NHQI represents a first step towards a more complete and open communication with consumers on the quality of care available in nursing homes that participate in the Medicare and Medicaid Programs.