BACKGROUND: 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. OBJECTIVE: To assess the availability, credibility and applicability of existing public reports of hospital and physician quality, with comparisons across geographic areas. APPROACH: 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. PARTICIPANTS: Interviewees included staff of state and local associations, health plan representatives and leaders of local health care alliances. RESULTS: 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 nonhealth 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. CONCLUSIONS: 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.
Bibliographical noteFunding Information:
Acknowledgements: 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.
- Provider performance
- Public reporting