Useful Consumer Health Reporting

Many questions have to be answered for the notion of providing consumers with quality and cost information about health care providers to be proven successful.  The measures chosen and reported on have to be linked to actual outcomes.  The actual measuring and analysis has to be done accurately.  The reports have to be made widely available to consumers in a form that they are likely to understand.  Consumers have to be willing to use the data to at least partly guide their provider selections and have to have a degree of health literacy that enables them to make good judgments.  New research in Health Affairs addresses at least one of these issues; how the data is presented to consumers.   (HA Article)   The authors first note that, as is true with most products and services, consumers tend to view higher-cost health care providers and products as better quality and lower-priced ones as substandard.  Price is a proxy for quality.  In reality, judged fairly objectively, the relationship is rarely this straightforward.  The researchers then explored different presentation methods for price and quality data to help consumers make good decisions.

The researchers divided the subjects into three groups, which each viewed six different ways of presenting cost data.   The subjects were then asked which providers they would choose, how confident they were in their choices and what they thought the highest-quality options were.  It should be noted that the participants were more highly educated, had higher incomes and were healthier than the general population.  The various options used different ways of presenting cost data on the providers and three options for quality, including basically no quality data.  One option also specifically highlighted high value, that is, low-cost, high-quality, providers.  Various “framing” and labeling statements were used with the data.  People were more likely to choose high value providers when the cost data was presented with stars or dollar amounts than with dollar signs and were slightly more likely to do so with stronger quality signals.  Describing resource use as “appropriate” was a better labeling or framing statement than other options tested.   The stronger the quality signals, the more confident participants were in their choice of provider.  There remained, however, a significant minority of consumers who always chose the higher-priced and higher-resource using physicians.   Financial incentives are needed to motivate this group, and to reward consumers making cost-effective choices.