Health Care

Both employers who purchase health care and individual consumers have demanded more information on quality. In response to these demands, some state, large employers, and health plans have been publishing performance reports describing the quality of health care providers. These "report cards" provide such information as the frequency with which preventive service are provided and the degree of success in treating certain diseases. Data comparing health care plans and providers helped consumers GAO surveyed make their health care purchasing decisions. However, performance reports have yet to achieve their fullest potential. Consumers said that they needed more reliable and valid data, readily available and standardized information, and emphasis on outcome measures. Meeting the information needs of individual consumers continues to lag behind meeting the employer needs. Attention must be paid to ensuring that individual consumers have access to health care data. Although employers themselves have begun to cooperate with one another, few GAO interviewed are making complete health care data available to help individual consumers make purchasing decisions. Relevant stakeholders have not yet addressed the issues of disseminating performance data to individual consumers so that they can make responsive, informed decisions about their health care coverage.

GAO found that: (1) employers and individuals use information that measures and compares the quality of health care furnished by providers and health plans when making purchasing decisions; (2) consumers want performance reporting efforts to continue and are requesting that more data be made publicly available; (3) consumers want standardized and comparable health care information to assess health care providers' or health plans' performance; (4) many employers get health care performance data through business coalitions, consultants, and their own data collection efforts; and (5) although employers have begun cooperating with one another to enhance their purchasing decisions, few employers make health care data available to their employees.