Study Suggests Ways to Improve Healthcare Provider 'Report Cards'

As healthcare reform expands the use of "report cards" to grade healthcare providers, greater attention to reporting methods may be needed to assure the quality of such efforts, according to a new RAND Corporation study.

"Public reports about the quality, efficiency and patient-centeredness of healthcare providers can do much to improve the nation's healthcare system," says Dr. Mark W. Friedberg, the study's lead author and researcher at RAND, a nonprofit research organization. "But if the performance reports are poorly constructed, they could needlessly disrupt existing clinical relationships and drive patients to inferior providers."

Writing in the March edition of the journal Health Affairs, Friedberg and colleague Cheryl L. Damberg outline a checklist to improve the methods behind healthcare performance reporting. The RAND Health checklist is intended to minimize the frequency and severity of misclassifying provider performance, and to avoid adverse and unintended consequences of reporting.

"Methods used to compare healthcare providers should be robust and transparent so that we can improve confidence in the accuracy of the reports," said Damberg, a RAND senior policy researcher. "Both healthcare providers and patients can benefit from such improvements."

Public reports about the performance of healthcare providers on quality, cost, patient satisfaction and outcomes have become increasingly common. Since 2004, Medicare's Hospital Compare website has posted public reports about the performance of most U.S. hospitals on a wide variety of measures. The Affordable Care Act of 2010 requires that another website be established by 2013 to report physician performance.

RAND researchers outline methods that can help government agencies and other groups create accurate and useful health care performance reports. The work builds on the pioneering efforts of RAND Health and other researchers in the area of health care quality.

Researchers say that when healthcare report cards are given to the public, there should be a mechanism in place to see whether the tools help achieve their intended goals, such as helping patients choose better-quality providers.

"We hope this work opens a wider discussion about how to improve the creation and dissemination of health care performance reports," Friedberg says. "While there are challenges to doing this work, we think report makers can overcome them if they have the right resources and expertise."

Support for the study was provided by the U.S. Agency for Healthcare Research and Quality.