Do Report Cards Predict Future Quality? The Case of Skilled Nursing Facilities

66 Pages Posted: 20 Jun 2019 Last revised: 17 Nov 2024

See all articles by Portia Cornell

Portia Cornell

Brown University

David C. Grabowski

Harvard University - Department of Health Care Policy

Edward C. Norton

University of Michigan at Ann Arbor

Momotazur Rahman

Brown University - Department of Health Services, Policy & Practice

Date Written: June 2019

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 affects 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 experience lower mortality, fewer days in the nursing home, and fewer hospital readmissions.

Suggested Citation

Cornell, Portia and Grabowski, David C. and Norton, Edward C. and Rahman, Momotazur, Do Report Cards Predict Future Quality? The Case of Skilled Nursing Facilities (June 2019). NBER Working Paper No. w25940, Available at SSRN: https://ssrn.com/abstract=3406455

Portia Cornell (Contact Author)

Brown University ( email )

David C. Grabowski

Harvard University - Department of Health Care Policy ( email )

25 Shattuck Street
Boston, MA 02115
United States

Edward C. Norton

University of Michigan at Ann Arbor ( email )

500 S. State Street
Ann Arbor, MI 48109
United States

Momotazur Rahman

Brown University - Department of Health Services, Policy & Practice ( email )

United States

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