A Report Card on Provider Report Cards: Current Status of the Health Care Transparency Movement
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Public reporting of provider performance can assist consumers in their choice of providers and stimulate providers to improve quality. Reporting of quality measures is supported by advocates of health care reform across the political spectrum.
To assess the availability, credibility and applicability of existing public reports of hospital and physician quality, with comparisons across geographic areas.
Information pertaining to 263 public reports in 21 geographic areas was collected through reviews of websites and telephone and in-person interviews, and used to construct indicators of public reporting status. Interview data collected in 14 of these areas were used to assess recent changes in reporting and their implications.
Interviewees included staff of state and local associations, health plan representatives and leaders of local health care alliances.
There were more reports of hospital performance (161) than of physician performance (103) in the study areas. More reports included measures derived from claims data (mean, 7.2 hospital reports and 3.3 physician reports per area) than from medical records data. Typically, reports on physician performance contained measures of chronic illness treatment constructed at the medical group level, with diabetes measures the most common (mean number per non-health plan report, 2.3). Patient experience measures were available in more hospital reports (mean number of reports, 1.2) than physician reports (mean, 0.7). Despite the availability of national hospital reports and reports sponsored by national health plans, from a consumer standpoint the status of public reporting depended greatly on where one lived and health plan membership.
Current public reports, and especially reports of physician quality of care, have significant limitations from both consumer and provider perspectives. The present approach to reporting is being challenged by the development of new information sources for consumers, and consumer and provider demands for more current information.
KEY WORDSpublic reporting provider performance quality
We thank Jessica Mittler, Patricia Keenan and two anonymous reviewers for their comments on various versions of the manuscript, as well as Bethany Shaw for her research assistance. Funding for this work was provided through a grant from The Robert Wood Johnson Foundation to The Pennsylvania State University for evaluation of the Foundation’s Aligning Forces for Quality initiative.
Conflict of Interest
- 1.Bernstein AB, Gauthier AK. Choices in health care: what are they and what are they worth? Med Care Res Rev. 1999;56(Supplemental: Power of Choice):5–23.Google Scholar
- 4.Berwick DM, James B, Coye MJ. Connections between quality measurement and improvement. Med Care. 2003;3(41):I30–8.Google Scholar
- 8.Department of Health and Human Services. Press Release. HHS secretary awards health leaders with special distinction for improving quality and value of health care. http://www.hhs.gov/news/press/2008pres/02/20080201a.html. Accessed June 15, 2010. 2008.
- 11.Harris KM, Buntin MB. Choosing a health care provider: The role of quality information. Research Synthesis Report No. 14. Princeton, NJ: The Synthesis Project. The Robert Wood Johnson Foundation, 2008.Google Scholar
- 12.Miller TP, Brennan TA, Milstein A. How can we make more progress in measuring physicians’ performance to improve the value of care? Health Aff. 28(5):1429–1437.Google Scholar
- 15.Alexander, Christianson, Hearld, Hurley, and Scanlon. Challenges of Capacity Building in Multi-sector Community Health Alliances. Health Education and Behavior. In press.Google Scholar
- 16.Department of Health and Human Services. About hospital compare. http://www.hospitalcompare.hhs.gov/Hospital/Search/Welcome.asp?version=default&browser=IE%7C7%7CWindows+Vista&language=English&defaultstatus=0&pagelist=Home. Accessed June 15, 2010.
- 17.The Leapfrog Group. The leapfrog group fact sheet. http://www.leapfroggroup.org/about_us/leapfrog-factsheet. Accessed June 15, 2010; 2009.
- 18.Tu HT, Hargraves JL. Seeking health care information: Most consumers still on the sidelines. Issue Brief No. 61. Washington, DC: Center for Studying Health System Change; 2003.Google Scholar
- 19.Fox S. Online health search 2006. (Pew Internet Project: October 29, 2006). http://www.pewinternet.org/Reports/2006/Online-Health-Search-2006.aspx. Accessed June 15, 2010; 2006.
- 20.Department of Health and Human Services, Health Information Technology For the Future of Health and Care. Regulations and Guidance. Meaningful Use. http://healthit.hhs.gov/portal/server.pt?open=512&objID=1496&parentname=CommunityPage&parentid=1&mode=2&in_hi_userid=10741&cached=true. Accessed June 15, 2010.
- 21.Kowalczyk L. Looking for Dr. Right; With more and more websites rating physicians, the question is: Can you trust them? Boston Globe. 2009;(June 8): G6.Google Scholar
- 22.Freudenheim M. Noted rater or restaurants brings its touch to medicine. The New York Times. February 16; 2009.Google Scholar
- 23.Freudenheim M. Zagat turns focus to medicine. New York Times, February 16, 2009. http://www.nytimes.com/2009/02/16/business/worldbusiness/16iht-16zagat.20207252.html?_r=1&scp=6&sq=zagat&st=cse. Accessed June 15, 2010
- 24.Scholle SH, Roski J, Dunn DL, Adams JL, Dugan DP, Pawlson LG, Kerr EA. Availability of data measuring physician quality performance. Am J Manage Care. 2009;15(1):67–72.Google Scholar
- 26.Choe HM, Bernstein SJ, Standiford CJ, Hayward RA. New diabetes HEDIS blood pressure quality measure: potential for overtreatment. Am J Manage Care. 2010;16(1):19–24.Google Scholar
- 27.Shubrook JH, Snow RJ, McGill SL, Brannan GD. “All-or-none” (bundled) process and outcome indicators of diabetes care. Am J Manage Care. 2010;16(1):25–a33.Google Scholar