Press Release

Embargoed Until Contact

March 28, 2012

Sue Ducat
Director of Communications
(301) 841-9962


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.

Consumers’ And Providers’ Responses To Public Cost Reports, And How To Raise The Likelihood Of Achieving Desired Results

By Ateev Mehrotra, Peter Hussey, Arnold Milstein, and Judith H. Hibbard

Mehrotra is an assistant professor at the University of Pittsburgh School of Medicine; Hussey is a policy researcher at the RAND Corporation in Arlington, VA; Milstein is a professor at Stanford University; and Hibbard is a senior researcher and a professor emerita at the University of Oregon in Eugene.


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.”

In A California Program, Quality And Utilization Reports On Reproductive Health Services Spurred Providers To Change

By Leslie A. Watts, Heike Thiel de Bocanegra, Philip D. Darney, Denis Hulett, Michael Howell, John Mikanda, Regina Zerne, and Michael S. Policar

Watts, Theil de Bocanegra, Darney, Hulett, Howell, and Policar are affiliated with the University of California, San Francisco (UCSF); Mikanda and Zerne are with the California Department of Public Health Office of Family Planning in Sacramento.

Research support by UCSF’s Bixby Center for Global Reproductive Health. Funding from the State of California, Department of Public Health, Office of Family Planning.


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 state’s 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 (January–June 2005 and January–June 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 You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.

The full text of each Health Affairs Web First paper is available free of charge to all Web-site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund.