R. Tamara Konetzka

Research Summary
R. Tamara Konetzka, PhD, is the Louis Block Distinguished Service Professor of Public Health Sciences in the Department of Public Health Sciences, with a secondary appointment in the Department of Medicine, Section of Geriatrics and Palliative Medicine. She is an internationally recognized expert in the health economics of long-term and post-acute care. Her research focuses on the incentives created by health care policy, including payment policy, and their effects on quality of care. She has been the PI on numerous major federal research grants, leading to significant advances in knowledge of the drivers of nursing home quality, how public reporting of quality changes the behavior of providers and consumers, and the unintended consequences of home-based long-term and post-acute care. In May 2020 and again in March 2021, she testified before the U.S. Senate on COVID-19 and nursing homes. Konetzka serves on several editorial boards and is Editor in Chief of Medical Care Research and Review.
Health Economics, Long-Term Care, Post-Acute Care, Medicaid, Medicare
  • University of Pennsylvania and Philadelphia VA, Post-doctoral fellowship Health Economics 06/2004
  • University of North Carolina at Chapel Hill, PhD Health Policy and Administration (Health Economics) 08/2003
  • University of Pennsylvania, AM Economics 12/1992
Biosciences Graduate Program Association
Awards & Honors
  • 2014 - - Invited member, Five-Star Quality Rating System Technical Expert Panel (TEP) Centers for Medicare and Medicaid Services
  • 2019 - - Standing Member NIH HSOD/ODHS Study Section
  • 2020 - - Member, Committee on the Quality of Care in Nursing Homes National Academy of Sciences, Engineering, and Medicine
  • 2020 - Invited Testimony on COVID-19 and Nursing Homes, US Senate Special Committee on Aging
  • 2021 - - Invited Testimony on COVID-19 and Nursing Homes US Senate Finance Committee
  1. Wasserman M, Konetzka RT. Beyond Compliance: A More Integrated Public Health Approach To Outbreaks In Nursing Homes And Other Disasters. Health Aff (Millwood). 2022 06; 41(6):831-837. View in: PubMed

  2. Werner RM, Konetzka RT, Grabowski DC, Stevenson DG. Reforming Nursing Home Financing, Payment, and Oversight. N Engl J Med. 2022 05 19; 386(20):1869-1871. View in: PubMed

  3. Jiao S, Konetzka RT, Pollack HA, Huang ES. Estimating the Impact of Medicaid Expansion and Federal Funding Cuts on FQHC Staffing and Patient Capacity. Milbank Q. 2022 06; 100(2):504-524. View in: PubMed

  4. Mukamel DB, Saliba D, Ladd H, Konetzka RT. Daily Variation in Nursing Home Staffing and Its Association With Quality Measures. JAMA Netw Open. 2022 03 01; 5(3):e222051. View in: PubMed

  5. Zimmerman S, Cesari M, Gaugler JE, Gleckman H, Grabowski DC, Katz PR, Konetzka RT, McGilton KS, Mor V, Saliba D, Shippee TP, Sloane PD, Stone RI, Werner RM. The Inevitability of Reimagining Long-Term Care. J Am Med Dir Assoc. 2022 02; 23(2):187-189. View in: PubMed

  6. Werner RM, Konetzka RT. Reimagining Financing and Payment of Long-Term Care. J Am Med Dir Assoc. 2022 02; 23(2):220-224. View in: PubMed

  7. Bressman E, Coe NB, Chen X, Konetzka RT, Werner RM. Trends in Receipt of Help at Home After Hospital Discharge Among Older Adults in the US. JAMA Netw Open. 2021 11 01; 4(11):e2135346. View in: PubMed

  8. Werner RM, Templeton Z, Apathy N, Skira MM, Konetzka RT. Trends in Post-Acute Care in US Nursing Homes: 2001-2017. J Am Med Dir Assoc. 2021 12; 22(12):2491-2495.e2. View in: PubMed

  9. Konetzka RT, White EM, Pralea A, Grabowski DC, Mor V. A systematic review of long-term care facility characteristics associated with COVID-19 outcomes. J Am Geriatr Soc. 2021 10; 69(10):2766-2777. View in: PubMed

  10. Schwartz ML, Rahman M, Thomas KS, Konetzka RT, Mor V. Consumer selection and home health agency quality and patient experience stars. Health Serv Res. 2022 02; 57(1):113-124. View in: PubMed

  11. Wang S, Temkin-Greener H, Simning A, Konetzka RT, Cai S. Medicaid home- and community-based services and discharge from skilled nursing facilities. Health Serv Res. 2021 12; 56(6):1156-1167. View in: PubMed

  12. Konetzka RT, Davila H, Brauner DJ, Cursio JF, Sharma H, Werner RM, Park YS, Shippee TP. The Quality Measures Domain in Nursing Home Compare: Is High Performance Meaningful or Misleading? Gerontologist. 2022 Feb 09; 62(2):293-303. View in: PubMed

  13. Miller KEM, Gorges RJ, Konetzka RT, Van Houtven CH. The Metrics Matter: Improving Comparisons of COVID-19 Outbreaks in Nursing Homes. J Am Med Dir Assoc. 2021 05; 22(5):955-959.e3. View in: PubMed

  14. Dong J, He D, Nyman JA, Konetzka RT. Wealth and the utilization of long-term care services: evidence from the United States. Int J Health Econ Manag. 2021 Sep; 21(3):345-366. View in: PubMed

  15. Sloane PD, Yearby R, Konetzka RT, Li Y, Espinoza R, Zimmerman S. Addressing Systemic Racism in Nursing Homes: A Time for Action. J Am Med Dir Assoc. 2021 04; 22(4):886-892. View in: PubMed

  16. Gorges RJ, Konetzka RT. Factors Associated With Racial Differences in Deaths Among Nursing Home Residents With COVID-19 Infection in the US. JAMA Netw Open. 2021 02 01; 4(2):e2037431. View in: PubMed

  17. Konetzka RT. Improving the Fate of Nursing Homes During the COVID-19 Pandemic: The Need for Policy. Am J Public Health. 2021 Apr; 111(4):632-634. View in: PubMed

  18. Coe NB, Konetzka RT, Berkowitz M, Blecker E, Van Houtven CH. The Effects of Home Care Provider Mix on the Care Recipient: An International, Systematic Review of Articles from 2000 to 2020. Annu Rev Public Health. 2021 04 01; 42:483-503. View in: PubMed

  19. Konetzka RT, Jung DH, Gorges RJ, Sanghavi P. Outcomes of Medicaid home- and community-based long-term services relative to nursing home care among dual eligibles. Health Serv Res. 2020 12; 55(6):973-982. View in: PubMed

  20. Konetzka RT, Gorges RJ. Nothing Much Has Changed: COVID-19 Nursing Home Cases and Deaths Follow Fall Surges. J Am Geriatr Soc. 2021 01; 69(1):46-47. View in: PubMed

  21. Davila H, Shippee TP, Park YS, Brauner D, Werner RM, Konetzka RT. Inside the Black Box of Improving on Nursing Home Quality Measures. Med Care Res Rev. 2021 12; 78(6):758-770. View in: PubMed

  22. Gorges RJ, Konetzka RT. Staffing Levels and COVID-19 Cases and Outbreaks in U.S. Nursing Homes. J Am Geriatr Soc. 2020 11; 68(11):2462-2466. View in: PubMed

  23. Van Houtven CH, Konetzka RT, Taggert E, Coe NB. Informal And Formal Home Care For Older Adults With Disabilities Increased, 2004-16. Health Aff (Millwood). 2020 08; 39(8):1297-1301. View in: PubMed

  24. Shashikumar SA, Huang K, Konetzka RT, Joynt Maddox KE. Claims-based Frailty Indices: A Systematic Review. Med Care. 2020 09; 58(9):815-825. View in: PubMed

  25. Konetzka RT. The Challenges of Improving Nursing Home Quality. JAMA Netw Open. 2020 Jan 03; 3(1):e1920231. View in: PubMed

  26. Werner RM, Konetzka RT, Qi M, Coe NB. The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs. Health Serv Res. 2019 12; 54(6):1184-1192. View in: PubMed

  27. Perraillon MC, Konetzka RT, He D, Werner RM. Consumer Response to Composite Ratings of Nursing Home Quality. Am J Health Econ. 2019; 5(2):165-190. View in: PubMed

  28. Busch SH, Cohen MS, Konetzka RT. Assessing the Relative Contribution of Resident Versus Facility Characteristics Associated With Antipsychotic Medication Receipt Among Nursing Facility Residents. Med Care. 2019 10; 57(10):822-829. View in: PubMed

  29. Gorges RJ, Sanghavi P, Konetzka RT. A National Examination Of Long-Term Care Setting, Outcomes, And Disparities Among Elderly Dual Eligibles. Health Aff (Millwood). 2019 07; 38(7):1110-1118. View in: PubMed

  30. Chatterjee P, Qi M, Coe NB, Konetzka RT, Werner RM. Association Between High Discharge Rates of Vulnerable Patients and Skilled Nursing Facility Copayments. JAMA Intern Med. 2019 Sep 01; 179(9):1296-1298. View in: PubMed

  31. Sharma H, Perraillon MC, Werner RM, Grabowski DC, Konetzka RT. Medicaid and Nursing Home Choice: Why Do Duals End Up in Low-Quality Facilities? J Appl Gerontol. 2020 09; 39(9):981-990. View in: PubMed

  32. Davidson C, Loganathan S, Bishop L, Imhof L, Bergofsky L, Spector W, Konetzka RT. Scalability of an IT Intervention to Prevent Pressure Ulcers in Nursing Homes. J Am Med Dir Assoc. 2019 07; 20(7):816-821.e2. View in: PubMed

  33. Coe NB, Guo J, Konetzka RT, Van Houtven CH. What is the marginal benefit of payment-induced family care? Impact on Medicaid spending and health of care recipients. Health Econ. 2019 05; 28(5):678-692. View in: PubMed

  34. Werner RM, Coe NB, Qi M, Konetzka RT. Patient Outcomes After Hospital Discharge to Home With Home Health Care vs to a Skilled Nursing Facility. JAMA Intern Med. 2019 05 01; 179(5):617-623. View in: PubMed

  35. Konetzka RT, Yang F, Werner RM. Use of instrumental variables for endogenous treatment at the provider level. Health Econ. 2019 05; 28(5):710-716. View in: PubMed

  36. Konetzka RT, Lasater KB, Norton EC, Werner RM. Are Recessions Good for Staffing in Nursing Homes? Am J Health Econ. 2018; 4(4):411-432. View in: PubMed

  37. Brauner D, Werner RM, Shippee TP, Cursio J, Sharma H, Konetzka RT. Does Nursing Home Compare Reflect Patient Safety In Nursing Homes? Health Aff (Millwood). 2018 11; 37(11):1770-1778. View in: PubMed

  38. Dong J, Pollack H, Konetzka RT. Effects of long-term care setting on spousal health outcomes. Health Serv Res. 2019 02; 54(1):158-166. View in: PubMed

  39. Konetzka RT, Sharma H, Park J. Malpractice Environment vs Direct Litigation: What Drives Nursing Home Exit? Inquiry. 2018 Jan-Dec; 55:46958018787995. View in: PubMed

  40. Ryskina KL, Konetzka RT, Werner RM. Association Between 5-Star Nursing Home Report Card Ratings and Potentially Preventable Hospitalizations. Inquiry. 2018 Jan-Dec; 55:46958018787323. View in: PubMed

  41. Gonçalves J, Weaver F, Konetzka RT. Measuring State Medicaid Home Care Participation and Intensity Using Latent Variables. J Appl Gerontol. 2020 07; 39(7):731-744. View in: PubMed

  42. Liao JM, Konetzka RT, Werner RM. Trends in hospital-SNF relationships in the care of Medicare beneficiaries. Healthc (Amst). 2018 Sep; 6(3):175-179. View in: PubMed

  43. Werner RM, Konetzka RT. Trends in Post-Acute Care Use Among Medicare Beneficiaries: 2000 to 2015. JAMA. 2018 04 17; 319(15):1616-1617. View in: PubMed

  44. Konetzka RT, Skira MM, Werner RM. Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs. Am J Health Econ. 2018; 4(1):105-130. View in: PubMed

  45. Konetzka RT, Stuart EA, Werner RM. The effect of integration of hospitals and post-acute care providers on Medicare payment and patient outcomes. J Health Econ. 2018 09; 61:244-258. View in: PubMed

  46. Press VG, Konetzka RT, White SR. Insights about the economic impact of chronic obstructive pulmonary disease readmissions post implementation of the hospital readmission reduction program. Curr Opin Pulm Med. 2018 03; 24(2):138-146. View in: PubMed

  47. Perraillon MC, Brauner DJ, Konetzka RT. Nursing Home Response to Nursing Home Compare: The Provider Perspective. Med Care Res Rev. 2019 08; 76(4):425-443. View in: PubMed

  48. Sharma H, Konetzka RT, Smieliauskas F. The Relationship Between Reported Staffing and Expenditures in Nursing Homes. Med Care Res Rev. 2019 12; 76(6):758-783. View in: PubMed

  49. Konetzka RT, Werner RM. Relationships between Acute and Postacute Care Providers: Measurement and Estimation. Health Serv Res. 2017 10; 52(5):1621-1628. View in: PubMed

  50. Konetzka RT, Perraillon MC. Use Of Nursing Home Compare Website Appears Limited By Lack Of Awareness And Initial Mistrust Of The Data. Health Aff (Millwood). 2016 Apr; 35(4):706-13. View in: PubMed

  51. Werner RM, Skira M, Konetzka RT. An Evaluation of Performance Thresholds in Nursing Home Pay-for-Performance. Health Serv Res. 2016 Dec; 51(6):2282-2304. View in: PubMed

  52. Konetzka RT. Are Home- and Community-Based Services Cost-Effective? Med Care. 2016 Mar; 54(3):219-20. View in: PubMed

  53. Werner RM, Konetzka RT, Polsky D. Changes in Consumer Demand Following Public Reporting of Summary Quality Ratings: An Evaluation in Nursing Homes. Health Serv Res. 2016 Jun; 51 Suppl 2:1291-309. View in: PubMed

  54. Broyles IH, Sperber NR, Voils CI, Konetzka RT, Coe NB, Van Houtven CH. Understanding the Context for Long-Term Care Planning. Med Care Res Rev. 2016 06; 73(3):349-68. View in: PubMed

  55. Foley K, Konetzka RT, Bunin A, Yonan C. Prevalence of pseudobulbar affect symptoms and clinical correlates in nursing home residents. Int J Geriatr Psychiatry. 2016 07; 31(7):694-701. View in: PubMed

  56. Shah T, Churpek MM, Coca Perraillon M, Konetzka RT. Response. Chest. 2015 Oct; 148(4):e134-e135. View in: PubMed

  57. Konetzka RT, Brauner DJ, Coca Perraillon M, Werner RM. The Role of Severe Dementia in Nursing Home Report Cards. Med Care Res Rev. 2015 Oct; 72(5):562-79. View in: PubMed

  58. Konetzka RT, Grabowski DC, Perraillon MC, Werner RM. Nursing home 5-star rating system exacerbates disparities in quality, by payer source. Health Aff (Millwood). 2015 May; 34(5):819-27. View in: PubMed

  59. Van Houtven CH, Coe NB, Konetzka RT. Family structure and long-term care insurance purchase. Health Econ. 2015 Mar; 24 Suppl 1:58-73. View in: PubMed

  60. Guo J, Konetzka RT, Manning WG. The causal effects of home care use on institutional long-term care utilization and expenditures. Health Econ. 2015 Mar; 24 Suppl 1:4-17. View in: PubMed

  61. Shah T, Churpek MM, Coca Perraillon M, Konetzka RT. Understanding why patients with COPD get readmitted: a large national study to delineate the Medicare population for the readmissions penalty expansion. Chest. 2015 May; 147(5):1219-1226. View in: PubMed

  62. Guo J, Konetzka RT, Magett E, Dale W. Quantifying long-term care preferences. Med Decis Making. 2015 01; 35(1):106-13. View in: PubMed

  63. He D, Konetzka RT. Public Reporting and Demand Rationing: Evidence from the Nursing Home Industry. Health Econ. 2015 Nov; 24(11):1437-51. View in: PubMed

  64. Sperber NR, Voils CI, Coe NB, Konetzka RT, Boles J, Van Houtven CH. How Can Adult Children Influence Parents' Long-Term Care Insurance Purchase Decisions? Gerontologist. 2017 04 01; 57(2):292-299. View in: PubMed

  65. Konetzka RT. The hidden costs of rebalancing long-term care. Health Serv Res. 2014 Jun; 49(3):771-7. View in: PubMed

  66. Guo J, Konetzka RT, Dale W. Using time trade-off methods to assess preferences over health care delivery options: a feasibility study. Value Health. 2014 Mar; 17(2):302-5. View in: PubMed

  67. Konetzka RT, Brauner DJ, Shega J, Werner RM. The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment. J Am Geriatr Soc. 2014 Mar; 62(3):454-61. View in: PubMed

  68. Werner RM, Konetzka RT, Kim MM. Quality improvement under nursing home compare: the association between changes in process and outcome measures. Med Care. 2013 Jul; 51(7):582-8. View in: PubMed

  69. Konetzka RT, Park J, Ellis R, Abbo E. Malpractice litigation and nursing home quality of care. Health Serv Res. 2013 Dec; 48(6 Pt 1):1920-38. View in: PubMed

  70. Werner RM, Konetzka RT, Polsky D. The effect of pay-for-performance in nursing homes: evidence from state Medicaid programs. Health Serv Res. 2013 Aug; 48(4):1393-414. View in: PubMed

  71. Lindrooth RC, Konetzka RT, Navathe AS, Zhu J, Chen W, Volpp K. The impact of profitability of hospital admissions on mortality. Health Serv Res. 2013 Apr; 48(2 Pt 2):792-809. View in: PubMed

  72. Konetzka RT, Polsky D, Werner RM. Shipping out instead of shaping up: rehospitalization from nursing homes as an unintended effect of public reporting. J Health Econ. 2013 Mar; 32(2):341-52. View in: PubMed

  73. Konetzka RT, Karon SL, Potter DE. Users of Medicaid home and community-based services are especially vulnerable to costly avoidable hospital admissions. Health Aff (Millwood). 2012 Jun; 31(6):1167-75. View in: PubMed

  74. Navathe AS, Volpp KG, Konetzka RT, Press MJ, Zhu J, Chen W, Lindrooth RC. A longitudinal analysis of the impact of hospital service line profitability on the likelihood of readmission. Med Care Res Rev. 2012 Aug; 69(4):414-31. View in: PubMed

  75. Werner RM, Norton EC, Konetzka RT, Polsky D. Do consumers respond to publicly reported quality information? Evidence from nursing homes. J Health Econ. 2012 Jan; 31(1):50-61. View in: PubMed

  76. Hinami K, Whelan CT, Konetzka RT, Meltzer DO. Provider expectations and experiences of comanagement. J Hosp Med. 2011 Sep; 6(7):401-4. View in: PubMed

  77. Werner RM, Polsky D, Konetzka RT. The pay-off on nursing home report cards. LDI Issue Brief. 2011 Apr; 16(6):1-4. View in: PubMed

  78. Werner RM, Konetzka RT, Stuart EA, Polsky D. Changes in patient sorting to nursing homes under public reporting: improved patient matching or provider gaming? Health Serv Res. 2011 Apr; 46(2):555-71. View in: PubMed

  79. Park J, Konetzka RT, Werner RM. Performing well on nursing home report cards: does it pay off? Health Serv Res. 2011 Apr; 46(2):531-54. View in: PubMed

  80. Konetzka RT, Luo Y. Explaining lapse in long-term care insurance markets. Health Econ. 2011 Oct; 20(10):1169-83. View in: PubMed

  81. Hinami K, Whelan CT, Konetzka RT, Edelson DP, Casalino LP, Meltzer DO. Effects of provider characteristics on care coordination under comanagement. J Hosp Med. 2010 Nov-Dec; 5(9):508-13. View in: PubMed

  82. Werner RM, Konetzka RT. Advancing nursing home quality through quality improvement itself. Health Aff (Millwood). 2010 Jan-Feb; 29(1):81-6. View in: PubMed

  83. Konetzka RT, Werner RM. Applying market-based reforms to long-term care. Health Aff (Millwood). 2010 Jan-Feb; 29(1):74-80. View in: PubMed

  84. Konetzka RT. Do not-for-profit nursing homes provide better quality? BMJ. 2009 Aug 04; 339:b2683. View in: PubMed

  85. Werner RM, Konetzka RT, Stuart EA, Norton EC, Polsky D, Park J. Impact of public reporting on quality of postacute care. Health Serv Res. 2009 Aug; 44(4):1169-87. View in: PubMed

  86. Konetzka RT, Werner RM. Disparities in long-term care: building equity into market-based reforms. Med Care Res Rev. 2009 Oct; 66(5):491-521. View in: PubMed

  87. Werner RM, Konetzka RT, Kruse GB. Impact of public reporting on unreported quality of care. Health Serv Res. 2009 Apr; 44(2 Pt 1):379-98. View in: PubMed

  88. Konetzka RT, Zhu J, Sochalski J, Volpp KG. Managed care and hospital cost containment. Inquiry. 2008; 45(1):98-111. View in: PubMed

  89. Sochalski J, Konetzka RT, Zhu J, Volpp K. Will mandated minimum nurse staffing ratios lead to better patient outcomes? Med Care. 2008 Jun; 46(6):606-13. View in: PubMed

  90. Konetzka RT, Stearns SC, Park J. The staffing-outcomes relationship in nursing homes. Health Serv Res. 2008 Jun; 43(3):1025-42. View in: PubMed

  91. Konetzka RT, Spector W, Limcangco MR. Reducing hospitalizations from long-term care settings. Med Care Res Rev. 2008 Feb; 65(1):40-66. View in: PubMed

  92. Casalino LP, Alexander GC, Jin L, Konetzka RT. General internists' views on pay-for-performance and public reporting of quality scores: a national survey. Health Aff (Millwood). 2007 Mar-Apr; 26(2):492-9. View in: PubMed

  93. Konetzka RT, Norton EC, Stearns SC. Medicare payment changes and nursing home quality: effects on long-stay residents. Int J Health Care Finance Econ. 2006 Sep; 6(3):173-89. View in: PubMed

  94. Konetzka RT, Norton EC, Sloane PD, Kilpatrick KE, Stearns SC. Medicare prospective payment and quality of care for long-stay nursing facility residents. Med Care. 2006 Mar; 44(3):270-6. View in: PubMed

  95. Konetzka RT, Zhu J, Volpp KG. Did recent changes in Medicare reimbursement hit teaching hospitals harder? Acad Med. 2005 Nov; 80(11):1069-74. View in: PubMed

  96. Volpp KG, Konetzka RT, Zhu J, Parsons L, Peterson E. Effect of cuts in Medicare reimbursement on process and outcome of care for acute myocardial infarction patients. Circulation. 2005 Oct 11; 112(15):2268-75. View in: PubMed

  97. Konetzka RT, Spector W, Shaffer T. Effects of nursing home ownership type and resident payer source on hospitalization for suspected pneumonia. Med Care. 2004 Oct; 42(10):1001-8. View in: PubMed

  98. Konetzka RT, Yi D, Norton EC, Kilpatrick KE. Effects of Medicare payment changes on nursing home staffing and deficiencies. Health Serv Res. 2004 Jun; 39(3):463-88. View in: PubMed