Report cards lure patients to top-rated groups
Report cards lure patients to top-rated groups
Patients' choices are based on cost and quality
Do physician report cards influence health care consumers? A Minneapolis program suggests that they do, and that patients will make choices based on both cost and quality.
The Buyers Health Care Action Group allows members to choose among care systems, which include physician practices, hospitals, clinics, and other providers. Each care group is distinct; unlike the typical health plan, care networks do not overlap.
Care systems set their own budgets to provide care to their members and then are placed into low-, medium-, and high-cost groups, with a corresponding differential in premiums. Members also receive a patient satisfaction report that gives care systems three stars (better than average), two stars (average), or one star (below average).
In the 1998 enrollment period, low-cost systems gained enrollment. But systems with high satisfaction ratings also fared well, even if they were higher cost, says Steve Wetzell, executive director of policy and public affairs.
"We have two medical groups that are in our most expensive premium levels. One had high-satisfaction levels, and one had low-satisfaction levels," he says. "The group that had low satisfaction lost 18% of their patients. The group that had high satisfaction actually gained enrollment. What it indicates is that consumers are hungry for this information, and they will use it to pick their medical groups if it's made available to them," he says.
Program leaders would like to add measures of clinical quality, but there isn't enough patient volume to generate valid data, says Wetzell. Buyers Health Care Action Group currently covers 130,000 member-lives through 28 employers and is expanding into Sioux Falls, MN, with an additional 12 employers. The group may be able to obtain clinical data through partnerships with the state of Minnesota or other health care purchasers, Wetzell says. Meanwhile, Wetzell is pleased that members use both cost and quality information in their decisions. He acknowledges that this pattern differs from the findings of some researchers who say consumers don't use available report card information.
"We think, in fairness to consumers, they've never been given the opportunity to make an informed buying decision on health care," he says. "It's going to take some time for them to look at this information, learn how to use it, and [for it to] affect their decision on physicians or physician groups."Wetzell also says that furnishing quality measures on providers enhances consumer trust in managed care. "Our employers see this as an obligation to get this information to consumers if we're going to prove weas concerned about quality as we are about cost," he says.
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