scholarly journals Nursing Home 5-Star Rating System Exacerbates Disparities In Quality, By Payer Source

2015 ◽  
Vol 34 (5) ◽  
pp. 819-827 ◽  
Author(s):  
R. Tamara Konetzka ◽  
David C. Grabowski ◽  
Marcelo Coca Perraillon ◽  
Rachel M. Werner
Author(s):  
Kira L. Ryskina ◽  
R. Tamara Konetzka ◽  
Rachel M. Werner

Nursing homes’ publicly reported star ratings increased substantially since Centers for Medicare & Medicaid Services’s Nursing Home Compare adopted a 5-star rating system. Our objective was to test whether the improvements in nursing home 5-star ratings were correlated with reductions in rates of hospitalization. We hypothesized that increased attention to 5-star star ratings motivated nursing homes to make changes that improved their star ratings but did not affect their hospitalization rate, resulting in a weakened association between ratings and hospitalizations. We used 2007-2010 Medicare hospital claims and nursing home clinical assessment data to compare the correlation between nursing home 5-star ratings and hospitalization rates before versus after 5-star ratings were publicly released. The correlation between the rate of hospitalization and a nursing home’s 5-star rating weakened slightly after the ratings became publicly available. This decrease in correlation was concentrated among patients receiving post-acute care, who experienced relatively more hospitalizations from best-rated nursing homes. The improvements in nursing home star ratings after the release of Medicare’s 5-star rating system were not accompanied by improvements in a broader measure of outcomes for post-acute care patients. Although this dissociation may be due to better matching of sicker patients to higher-quality nursing homes or superficial improvements by nursing homes to increase their ratings without substantial investments in quality improvement, the 5-star ratings nonetheless became less meaningful as an indicator of nursing home quality for post-acute care patients.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 22-23
Author(s):  
Latarsha Chisholm ◽  
Akbar Ghiasi ◽  
Justin Lord ◽  
Robert Weech-Maldonado

Abstract Racial/ethnic disparities have been well documented in long-term care literature. As the population ages and becomes more diverse over time, it is essential to identify mechanisms that may eliminate or mitigate racial/ethnic disparities. Culture change is a movement to transition nursing homes to more home-like environments. The literature on culture change initiatives and quality has been mixed, with little to no literature on the use of culture change initiatives in high Medicaid nursing homes and quality. The purpose of this study was to examine how the involvement of culture change initiatives among high Medicaid facilities was associated with nursing home quality. The study relied on both survey and secondary nursing home data for the years 2017-2018. The sample included high Medicaid (85% or higher) nursing homes. The outcome of interest was the overall nursing home star rating obtained from the Nursing Home Compare Five-Star Quality Rating System. The primary independent variable of interest was the years of involvement in culture change initiatives among nursing homes, which was obtained from the nursing home administrator survey. The final model consisted of an ordinal logistic regression with state-level fixed effects. High-Medicaid nursing homes with six or more years in culture change initiatives had higher odds of having a higher star rating, while facilities with one year or less had significantly lower odds of having a higher star rating. Culture change initiatives may require some time to effectively implement, but these initiatives are potential mechanisms to improve quality in high Medicaid nursing homes.


2020 ◽  
Vol 35 (10) ◽  
pp. 1553-1561
Author(s):  
Daniel Shin ◽  
Denis Darpy

Purpose Product ratings and reviews are popular tools to support buying decisions of consumers. Many e-commerce platforms now offer product ratings and reviews as ratings and reviews are valuable for online retailers. However, luxury goods industry is somewhat slow to adapt to the digital terrain. The purpose of this paper is to answer “how luxury consumers see user-generated product ratings and reviews for their online shopping experience and what important factors or values are perceived by the luxury consumers when they shop online?” Design/methodology/approach To understand how luxury consumers use product ratings and reviews before buying online, a survey with a situational set up of variations of rating, review and price options in association with a number of hypothetical luxury goods was conducted among 421 global luxury consumers out of over 6,000 people. The study was carried out from September to October 2018 for six weeks in the form of online and mobile survey. User population is high net-worth individuals or luxury consumers derived from the author’s various professional and social networks and communities. Their geographical coverage would be global, but concentrated around the major cities. Findings The survey shows that ratings and reviews can be important source of information for luxury consumers. Online ratings and reviews are rated as helpful by 76.01% of the participants. People who chose the highly rated one (4.8/5) over the poorly rated (3.7/5) was 86.94%, while all else such as product category, star rating and price range are about the same. Feedback from the open question survey indicates that the perceived helpfulness of rating and review systems could vary. Comparing user reviews is time-consuming because of unstructured nature of contextual reviews and the relative nature of human perception on the rating scale. Research limitations/implications There are two aspects of ratings and reviews playing an important role for luxury consumers’ buying decision. First, it is about helpfulness of collective rating score. Luxury consumers see a user-generated rating score and use the score when they make a choice even if the rating is not an absolute, but relative figure, not exactly like the star rating system in the hotel industry. Second, there is discrepancy between the status of the brand in association with its price position and perceived value as the industry does not cope with classifying their brands in any official star rating system. Practical implications Consumers need compact and concise information about the products they need. When there are only a few potential products left in their short wish-list, full user reviews can be helpful to get more details and general opinions about the products on the short list before making a final decision. In that regard, a primary indicator that will guide through the decision-making process of the luxury consumers would be the trustworthiness of user rating of each product in an aggregated score along with a potential use of sub-ratings, which has to be visible from the product landing page. Originality/value Even if there is a wide use and ubiquitous nature of product ratings and reviews in other consumer products, the author is curious about how luxury consumers use ratings and reviews for their buying decision because there are not that many researches done previously in spite of the importance of this issue. Luxury goods industry has hit €320bn in 2017 according to Bain and Co., and 25% of the trading volume will be replaced by the digital commerce by 2025.


Author(s):  
Antonios Antypas ◽  
Guglielmo Maria Caporale ◽  
Nikolaos Kourogenis ◽  
Nikitas Pittis

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