title: Public reporting and market area exit decisions by home health agencies.
abstract: OBJECTIVE
  To examine whether home health agencies selectively discontinue services to areas with socio-economically disadvantaged people after the introduction of Home Health Compare (HHC), a public reporting program initiated by Medicare in 2003.
  We focused on agencies' initial responses to HHC and examined selective market-area exits by agencies between 2002 and 2004. We measured HHC effects by the percentage of quality indicators reported in public HHC data in 2003. Socio-economic status was measured by per capita income and percent college-educated at the market-area level.
  
  
  METHODS
  2002 and 2004 Outcome and Assessment Information Set (OASIS); 2000 US Census file; 2004 Area Resource File; and 2002 Provider of Service File.
  
  
  RESULTS
  WE FOUND A SMALL AND WEAK EFFECT OF PUBLIC REPORTING ON SELECTIVE EXITS: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with less-educated people by 0.3 percentage points, compared with leaving an area with high education.
  
  
  CONCLUSIONS
  The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program.
authors.affiliation: The Pennsylvania State University-College of Health and Human Development.
authors.forename: Kyoungrae
authors.initials: K
authors.lastname: Jung
authors.affiliation: University of Minnesota-School of Public Health.
authors.forename: Roger
authors.initials: R
authors.lastname: Feldman
mesh_terms: D030881:Disclosure; D018574:Home Care Agencies / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D019221:Mandatory Reporting; D008389:Marketing of Health Services / Q000458:organization & administration / Q000706:statistics & numerical data; D006278:Medicare / Q000458:organization & administration; D019984:Quality Indicators, Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States
keywords: Home Health Care; Home Health Compare; Market-area Exits; Public Reporting; Selection Incentives