Will Quality Report Cards Help Consumers?

Abstract

This study assesses the relationship between the salience of quality information and how well it is understood by consumers. The analysis is based on survey data and content analysis from focus-group data (104 participants). The findings show that poorly understood indicators are viewed as not useful. Consumers often do not understand quality information because they do not understand the current health care context. All of this suggests that salience alone is not sufficient to determine which indicators should be included in report cards.T HE HEALTH CARE SECTOR is changing rapidly, and those changes have profound implications for consumers. Because an increasing percentage of the population is entering managed care, choice of plans may be more consequential than ever before. In particular, managed care offers new incentives to encourage providers to limit care and do less for patients. Quality information and informed consumer choice could be key counterbalances to these incentives. The assumption is that the collective effect of consumer choices will exert market-style constraints on costs and give plans the incentive to continuously improve care. Thus, the expectation is that consumers' ability to compare and judge competing health plans using plan performance data will play a crucial role in reforming health care. 1Because the public has not had access to comparative information on quality, it is not known whether consumers will use this information. Consumers' criteria for choosing health plans have been relatively simple.2 The degree to which consumers will expand these criteria to include quality information in selecting health plans is largely unknown.Despite minimal evidence about their effects on consumer behav-

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…760 -762,766 With implementation of healthcare reform legislation that increases access of consumers and payers to objective data and more easily understood data presentations, the influence of public report cards is likely to increase in the future. 762,[767][768][769][770][771] As this occurs, it will be important to monitor unintended negative consequences, such as "gaming" of the reporting system 772 and avoidance of high-risk patients (risk aversion), the precise group of patients who are most likely to benefit from aggressive intervention. [773][774][775][776] Methodological considerations are important for provider profiling and public reporting.…”

Consumer Reports in Health Care: Do They Make a Difference?

“…Hibbard & Jewett (14,15,18) published a series of papers using focus groups to identify useful indicators of quality to include in report cards. In their research (14), they studied three groups: privately insured, uninsured, and members of Oregon's Health Plan, which provides managed care to Medicaid recipients.…”

How Do Patients Choose Physicians? Evidence from a National Survey of Enrollees in Employment‐Related Health Plans

“…These studies measured consumers' understanding of and preferences for various dimensions of health care quality and measurement approaches and are useful for predicting consumers reactions to physician-level quality measures, though to date such measures are not publicly reported on a widespread basis. Hibbard and Jewett (1997) conducted focus groups to determine why some consumers fail to use available quality information in making plan and provider choices. They found that consumers lack understanding of the organization and delivery of care in managed care settings and that consumers tend to rely on more fully understandable measures, such as interpersonal skills of providers.…”