Center for Gerontology and Health Care Research
121 South Main Street, S-6
Institutional Affiliation: Brown University
NBER Working Papers and Publications
|June 2019||Do Report Cards Predict Future Quality? The Case of Skilled Nursing Facilities|
with Portia Y. Cornell, David C. Grabowski, Edward C. Norton: w25940
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.
Published: 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. citation courtesy of
|August 2016||Do Hospital-Owned Skilled Nursing Facilities Provide Better Post-Acute Care Quality?|
with Edward C. Norton, David C. Grabowski: w22515
As hospitals are increasingly held accountable for patients' post-discharge outcomes under new payment models, hospitals may choose to acquire skilled nursing facilities (SNFs) to better manage these outcomes. This raises the question of whether patients discharged to hospital-based SNFs have better outcomes. In unadjusted comparisons, hospital-based SNF patients have much lower Medicare utilization in the 180 days following discharge relative to freestanding SNF patients. We solved the problem of differential selection into hospital-based and freestanding SNFs by using differential distance from home to the nearest hospital with a SNF relative to the distance from home to the nearest hospital without a SNF as an instrument. We found that hospital-based SNF patients spent roughly 5 more da...
Published: Momotazur Rahman & Edward C. Norton & David C. Grabowski, 2016. "Do hospital-owned skilled nursing facilities provide better post-acute care quality?," Journal of Health Economics, . citation courtesy of