Author Contributions: Dr Kernisan had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Kernisan, Dudley.
Acquisition of data: Kernisan, Dudley.
Analysis and interpretation of data: Kernisan, Lee, Boscardin, Landefeld, Dudley.
Drafting of the manuscript: Kernisan, Dudley.
Critical revision of the manuscript for important intellectual content: Kernisan, Lee, Boscardin, Landefeld, Dudley.
Statistical analysis: Kernisan, Boscardin, Dudley.
Obtained funding: Dudley.
Administrative, technical, or material support: Kernisan, Dudley.
Study supervision: Lee, Landefeld, Dudley.
Financial Disclosures: Dr Dudley reported serving as an occasional consultant for the Leapfrog Group (but that he is not paid for this work) and serving on the Leapfrog Group's Hospital Rewards Program Steering Committee. Work on this article was not financially supported by the Leapfrog Group. Drs Kernisan, Lee, Boscardin, and Landefeld reported no financial or other conflicts of interest.
Funding/Support: This study was supported by the UCSF Division of Geriatrics, the UCSF Institute for Health Policy Studies, and the San Francisco VA Medical Center. Dr Kernisan was supported by T32 research fellowship grant 2 T32 AG000212-16 from the National Institute on Aging, National Institutes of Health, followed by a VA Quality Scholars fellowship. Dr Dudley's work was supported by a Robert Wood Johnson Foundation Investigator Award in Health Policy. This study was also supported by the Leapfrog Group, which provided its data at no cost.
Role of the Sponsor: The Leapfrog Group was involved in the design of the study and provided data but had no role in the analysis or interpretation of the data; the group had no role in the preparation of the manuscript and was not asked to approve the final manuscript but did review the manuscript and provided minor corrections of factual statements about its survey program. The Robert Wood Johnson Foundation had no role in the design of the study, the analysis of data, or the preparation of the manuscript.
Additional Contributions: We thank the Leapfrog Group for sharing its data with us.