Today, steadily increasing numbers of hospitals and health plans are
publicly releasing performance reports on the quality of care to permit comparisons
across different providers. Our experience in recent years has provided important
new evidence of what public quality reporting can accomplish and the difficulties
it faces. Several years ago, the most important impediments to quality reporting
may have been the availability of acceptable quality indicators and the feasibility
of voluntary, standardized data collection by health plans. We have made strides
in these areas. The Health Employer Data and Information Set (HEDIS) has expanded,
and there have been new innovations in collecting data on quality from both
patients and physicians. Hundreds of health plans have begun to report standardized
quality data on a routine basis either voluntarily or in response to requirements
from the Health Care Financing Administration, state Medicaid agencies, or
private payers. Now, the more formidable barriers to the use of quality report
cards may relate to the ways we report the data and use it. We need to find
acceptable middle ground for those who believe information on individual physicians
is critical and those who believe it is harmful. We need to reap the advantages
in different modalities of data collection and different tools for quality
management. Most of all, we need to find better ways to use quality reporting
to empower purchasers and consumers and improve quality of care.
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