The Cost and Quality of Culture Change

Empirical Investigation

A recent study (Elliot, 2007) used participation in the network as the treatment variable to assess any differences in quality of care and financial outcomes between network participants and non-participant nursing homes. For example, an investigation into quality of care outcomes for early adopter homes utilized a cross-sectional study analyzing outcomes in 2003 and found that length of time participating in the network was associated with positive outcomes over all other homes monitored by the Centers for Medicare and Medicaid Services in the country. The study also matched early adopter homes of the Pioneer Network to analogous non-participant homes and found that, from the 1996 to 2003 timeframe, early adopter homes achieved better quality outcomes when compared to the matched group of non-participant homes. In addition, homes participating in the Pioneer Network outperformed the control homes in the financial outcomes of per bed net income and improved operating margin. Examples of findings include the following highlights:


                




             

• Early adopter homes participating in the network experienced fewer survey citations than the Centers for Medicare and Medicaid Service dataset of the national sample of homes in 2003 (Figure 1)
• Early adopter homes participating in the network achieved better differences in quality of care outcomes (as measured by survey citations) than comparable non-participant homes from the 1996 to 2003 timeframe (Figure 2)
• Early adopter homes participating in the network achieved better differences in per bed net income and operating margins than comparable non-participant homes from the 1996 to 2003 timeframe (Figure 3 and Figure 4)

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