Whatever their philosophical bias, few policymakers would argue the importance of adequate information describing differences among health care providers in quality, cost, and availability of services. In particular, such information is widely viewed as essential to improving the quality of health through consumer choice. Thus, advocates of many points of view have pressed for the development of new mechanisms for collecting and disseminating comparative data about health services.The uses of comparative provider information, however, have rarely been subject to empirical test. No one knows very much about how consumers and their agents respond to such information or how such responses influence provider behavior in turn. This DataWatch reports the results of a "natural experiment" in the impact of public release of provider-specific quality data. The HCFA "Death List"In 1985 and 1986, the Health Care Financing Administration (HCFA) analyzed Medicare data as part of an effort to refine and better target peer review organization (PRO) and administrative oversight of Medicare providers. The analyses involved constructing multivariate models to predict hospital-specific mortality rates for Medicare patients discharged in 1984 and comparing those predicted rates with actual rates. Those comparisons identified 269 hospitals as "outliers," approximately half of which had higher-than-predicted mortality, and half lower. Additional analyses, less widely reported, applied the same methodology to nine specific diagnosis-related groups (DRGs).

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