Health Care Reform:

'Report Cards' Are Useful but Significant Issues Need to Be Addressed

HEHS-94-219: Published: Sep 29, 1994. Publicly Released: Sep 29, 1994.

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Pursuant to a congressional request, GAO reviewed the development of health care report cards, focusing on the: (1) approaches that should be used to develop health care performance measures; (2) opportunities to misrepresent health care data; and (3) potential uses of report cards by consumers, providers, and health plans.

GAO found that: (1) report cards can be useful to educate the public on health plan services; (2) although most experts believe that publishing health care report cards can help preserve health care quality and lower overall health care costs, they disagree about the type and amount of information to be published in such report cards because the data sources and evaluation methods may not be reliable or reflect the needs of some users; (3) reliable and valid report cards could be produced within 2 to 5 years if data sources continue to become more accurate and the appropriate indicators are used; (4) some experts believe that highly reliable and valid measures will not be developed in the near future; (5) although several states and health care organizations have released report cards on the care they provide, there has not been any evaluation to determine whether these report cards are valid or reliable; (6) the obstacles to using health care report cards include inaccurate, misleading, or incomplete information sources, indicators that do not measure quality, disagreement on formulas for calculating performance, and the lack of verification mechanisms to ensure result accuracy; (7) the federal government should standardize performance indicators and the formulas for calculating results and an independent third party should verify data before the report cards are published; and (8) consumers, providers, and health care plans could use report cards to select health plans, meet national public health care goals, identify areas that need improvement, and meet individual health care needs.

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