Public Opinion About Health Care - Report Cards May Help Consumers Make Informed Choices

Report cards that grade health plans, hospitals, and other providers offer consumers a way to make accurate comparisons and informed choices. Since the early 1990s the number of agencies, organizations, and employer coalitions issuing report cards has grown. In 1995 the federal government initiated the Consumer Assessment of Health Plans Study (CAHPS) to develop a consumer information project. By 1999, nine million federal employees had access to CAHPS data about available health plans. In 2002 Medicare beneficiaries also gained access to CAHPS data about Medicare managed care plans. CAHPS data are available to the public in print and on the Internet.

Many federal and state employees as well as workers employed in large corporations have become accustomed to comparing health plans using report cards, but report cards examining the quality of health care systems are relatively new additions to quality improvement and consumer education programs. Researchers from the Health Research Center, Park Nicollet Institute, and Minnesota Health Data Institute studied consumer response to report cards that compared health care systems that deliver care rather than health plans that provide insurance coverage. Barbara Braun and her colleagues published their findings in American Journal of Managed Care (vol. 8, no. 6, June 2002).

The report cards that the study participants were given measured seven aspects of care:

• Obtaining care without long waits
• Physician-patient communication
• Courtesy of office staff
• Ease of obtaining needed medical care
• Overall rating of the clinic experience
• Rating of health care provided
• Rating of the health care provider

The investigators found that most study participants had been unaware of the widespread use of report cards to compare health plans and the more recent use of them to measure and compare health service delivery. Nonetheless, the survey participants were very interested in quality measurement and considered report cards to be most valuable in two different circumstances—when they were faced with the personal choice of health care delivery system, and as a way to direct system-wide quality improvement efforts. Participants felt they would be most likely to consider report card data if they were dissatisfied with their current providers of medical care. Many said their own personal experiences and the opinions of friends and family would remain their primary and most trusted means of evaluating health care quality.