|March 28, 2012||
From Health Affairs
New Studies About Public Reporting
Bethesda, MD -- Two new studies, released online today as Web First articles by Health Affairs, focus on the effectiveness of current public reporting efforts to improve quality and lower costs. Both studies will also appear in the April issue of Health Affairs.
As the Affordable Care Act reached its two-year anniversary, a current focus is finding new approaches of reducing costs. Public reporting of performance and costs is one such approach. However, according to the authors, consumers might not use the cost information in the manner expected. The reports are not user-friendly; the data often fail to provide patient out-of-pocket costs; and many consumers think that more care is better and that higher-cost providers are higher-quality providers.
To address some of these concerns, the authors propose four key changes to the current patient selection pathway: focusing on choices consumers make most often, such as choosing a primary care provider; presenting clear copayment information; making sure cost and quality information are displayed side by side; and incentivizing consumers to switch providers. Additionally, public reporting creates a reputation pathway among providers peers, which can motivate poor performers to improve. In the context of the great urgency of national efforts to curb health care spending the authors conclude that it is possible to pursue both pathways simultaneously and thereby realize even more change.
According to the authors, the need to develop unique performance indicators for reproductive health services has received little attention. This study looked at a program which has tried to fill that void: the California Family PACT (Planning, Access, Care, and Treatment) Program, established by that states legislature in 1996 to reduce unintended pregnancies among low-income residents.
The study assessed whether the behavior of providers in the program was influenced by performance reports that used administrative and claims data for both quality improvement and utilization management. A total of 1,058 private-sector providers and 532 public-sector providers were included in the sample, taken during two intervals (JanuaryJune 2005 and JanuaryJune 2009). The providers were evaluated for six reproductive measures, and the study compared individual profiles from both periods for evidence of change in performance.
The authors found that change occurred in five of six indicators among private providers and in three of six indicators among public providers. The provider profiles project represents a promising first step in reporting to providers on the quality of their delivery of reproductive health services, concluded the authors. We believe the evidence suggests that providers changed their behavior when they were presented with performance reports that used administrative and claims data to compare them with their peers.
|About Health Affairs|
Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at www.healthaffairs.org. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.