Public Reporting of NH Antipsychotic Use: Changes in the Reporting of Exclusionary Diagnoses?

In this proposed pilot study, we aim to examine the use of exclusionary diagnoses around the 20-resident threshold for the long-stay APM quality measure to understand whether NHs have been gaming CMS’ public reporting system for APMs. The ultimate goal is to collect preliminary data in order to write a larger NIH funded grant proposal that will include Medicare/Medicaid claims data that document diagnoses outside of the NH (e.g. physicians and hospitals) and to study the issue of gaming for other quality measures reported on NH Compare. We hope to next link both the intended and unintended effects of this policy on APM access to the health outcomes of NH residents, to better understand how these policies affect health at later life.