Limited Use of Price and Quality Advertising Among American Hospitals

Abstract

BackgroundConsumer-directed policies, including health savings accounts, have been proposed and implemented to involve individuals more directly with the cost of their health care. The hope is this will ultimately encourage providers to compete for patients based on price or quality, resulting in lower health care costs and better health outcomes.ObjectiveTo evaluate American hospital websites to learn whether hospitals advertise directly to consumers using price or quality data.MethodsStructured review of websites of 10% of American hospitals (N=474) to evaluate whether price or quality information is available to consumers and identify what hospitals advertise about to attract consumers.ResultsOn their websites, 1.3% (6/474) of hospitals advertised about price and 19.0% (90/474) had some price information available; 5.7% (27/474) of hospitals advertised about quality outcomes information and 40.9% (194/474) had some quality outcome data available. Price and quality information that was available was limited and of minimal use to compare hospitals. Hospitals were more likely to advertise about service lines (56.5%, 268/474), access (49.6%, 235/474), awards (34.0%, 161/474), and amenities (30.8%, 146/474).ConclusionsInsufficient information currently exists for consumers to choose hospitals on the basis of price or quality, making current consumer-directed policies unlikely to realize improved quality or lower costs. Consumers may be more interested in information not related to cost or clinical factors when choosing a hospital, so consumer-directed strategies may be better served before choosing a provider, such as when choosing a health plan.

Factors Influencing Patient Selection of a Foot and Ankle Surgeon

“…8 Although board certification (highest rated factor by respondents) may be considered as a proxy for quality, a recent study of 474 US hospitals found that only 5.7% included quality outcomes information in their advertising. 14 Rather than formulate advertisements around quality metrics, most hospitals compete primarily on amenities, conveniences, and other aspects of the patient experience. 14 Interestingly, the availability of on-site imaging was rated second highest by respondents among selection factors for a foot and ankle surgeon.…”

“…14 Rather than formulate advertisements around quality metrics, most hospitals compete primarily on amenities, conveniences, and other aspects of the patient experience. 14 Interestingly, the availability of on-site imaging was rated second highest by respondents among selection factors for a foot and ankle surgeon. It remains unclear whether patients’ preference for on-site imaging and indifference toward advertisements (as suggested by our findings) are mutually exclusive.…”

Hospital Advertising, Competition, and HCAHPS: Does It Pay to Advertise?

“…Goldman, Vaiana, and Romley () report that a hospital experienced a 20 percent increase in its HCAHPS “Recommend the Hospital” score after it began advertising luxurious rooms, gourmet meals, and hotel‐like services. Muhlestein, Wilks, and Richter () found that over 72 percent of hospitals’ website content focused on access or amenities, which they related to patients’ perceptions of their experience of care. How advertising expenditures affect patients’ responses to HCAHPS survey questions remains unclear, since the surveys are administered after the patient has chosen the hospital, received treatment, and been discharged.…”

Why Do So Few Consumers Use Health Care Quality Report Cards? A Framework for Understanding the Limited Consumer Impact of Comparative Quality Information

“…Little data exists on how hospitals use CQI in their marketing efforts (Muhlestein, Wilks, & Richter, 2013). Insofar as they advertise CQI, hospitals have tended to spotlight patient satisfaction scores (e.g., HCAHPS “Recommend the Hospital” score) rather than clinical quality measures, perhaps because many patients find the latter confusing (Austin et al, 2015; Latham, 2004; Rothberg et al, 2008; Zuger, 2015).…”

“…Insofar as they advertise CQI, hospitals have tended to spotlight patient satisfaction scores (e.g., HCAHPS “Recommend the Hospital” score) rather than clinical quality measures, perhaps because many patients find the latter confusing (Austin et al, 2015; Latham, 2004; Rothberg et al, 2008; Zuger, 2015). Studies tend to find a positive relationship between hospitals’ HCAHPS scores and their advertising outlays, noting that the advertisements relate mainly to the amenities provided by hospitals and not clinical excellence or quality scores (Goldman, Vaiana, & Romley, 2010; Huppertz, Bowman, Bizer, Sidhu, & McVeigh, 2017; Muhlestein et al, 2013). These developments have attracted both criticism (Finn, 2001; Larson, Schwartz, Woloshin, & Welch, 2005; Schenker, Arnold, & London, 2014) and praise (Babakus & Cavusgil, 1988; Bordonaro, 2012).…”