Background

Providing public reports for consumers that compare the quality and cost of hospitals, medical groups, and health plans has become a growing strategy for communities working to improve the quality of health care. In addition to moving toward a more transparent health care system that enables consumer choice, public reporting web sites help local providers identify areas for quality improvement and guide purchasers and employers to make value-based purchasing decisions. While consumer use of these tools is still growing, early evidence suggests that public reporting of quality information does lead to performance improvements by clinician groups and nursing homes.[1]^,[2]

Since 2008, multi-stakeholder collaboratives (or Alliances) funded by the Robert Wood Johnson Foundation’s Aligning Forces for Quality (AF4Q) program have launched or expanded public reporting sites that enable consumers to see comparisons between local healthcare providers on a variety of health measures such as resource use, chronic condition management outcomes, and/or patient experience ratings. In addition, several Alliances have begun developing displays that allow consumers to compare the costs of care or the efficiency (or resource use) of these providers. The efforts of the Alliance communities have produced invaluable insights into the process of establishing public quality and cost reports. The insights center on the importance of and strategies for collaborating with providers, payers, purchasers, and consumers to establish provider buy-in and to display consumer-friendly data that engages consumers in health care decision-making. These lessons learned add to a growing set of evidence-based practices that will assist other organizations in displaying credible quality and cost information in an effective way, potentially stimulating behavior change and action to improve the value of health care. This brief summarizes the key learnings from those efforts, focusing on the evidence gathered to garner multi-stakeholder buy-in and develop consumer-friendly displays of quality and then cost.

The Goal of Public Reports:  Educating and Engaging Multiple Audiences

Public reports provide valuable information for a variety of audiences:

• For providers, public reports of quality and cost expose gaps or variations in performance that otherwise may have gone unnoticed. Comparative performance information can help drive competition, motivating health care delivery organizations to improve their quality, reassess their pricing, or create new efficiencies. For example, a multi-stakeholder collaborative in Minnesota leading both public reporting and quality improvement efforts found physician compliance with guidelines on appropriate use of asthma medications rose from 74 percent to more than 90 percent.[3]
• For consumers, clear comparisons of the things that matter most—patient experience ratings, chronic condition management, and cost of care—contribute to the process of choosing a provider and has the potential to encourage decisions that are based on performance and value, rather than referral or reputation. Demand for and use of quality and cost information for decision-making may increase as public reports become more accessible and relevant to consumers, particularly to those in high-deductible health plans.
• For employers and purchasers, public reports can help drive high-value purchasing decisions and enable clear comparisons among local providers that can better support the options that are available to employees or beneficiaries.