Why Talk About Health Care Quality?

In America, we worry about the quality of the cars we drive, the air we breathe, and the food we eat. But in the context of health care, we’ve tended to take quality for granted. It’s not that we didn’t care about quality, of course, but that we were confident of the high standard of care practiced by our providers.

Quality Isn’t Dependable

Now Americans are not so confident. Surveys show that health care is the number one concern among voters today.  The cry for Federal legislation to protect patients’ rights reflects a growing anxiety about quality—fear that we won’t get the care we need when we need it.

And researchers have confirmed that our fears are valid. The quality of health care in this country is not ideal: quality varies widely across health plans and providers. Many procedures and therapies are used too often while others are not used often enough. No institution or office is free from errors. And these problems are pervasive. Although most of the information we have comes from managed care organizations, we now see that quality is uneven throughout the industry—not only in health plans, but also in physicians’ offices, nursing homes, hospitals, and home health care agencies.

What makes this National anxiety especially powerful is how little we really know. We may be aware that some health plans and some providers deliver poor quality care, but the real issue for people is much more personal. What about my health plan? How good is my doctor? How do I choose among the options available to me?

Information Can Help

When these kinds of quality issues come up in other industries (such as concerns about automobile safety), the solution typically involves a multitude of strategies, including regulatory reforms, financial incentives, independent oversight, and consumer education. While this last tactic is only one piece of a much larger puzzle, the act of providing people with useful information plays a key role in effecting change.

Why is public information so effective?

Information is empowering.

By revealing the truth about quality, information makes consumers aware of what they are really getting and enables them to make decisions that reflect their needs and their values. Nutrition labels, for instance, made people conscious of their consumption in a new way; for the first time, they were able to judge the quality of food, compare products, and make informed decisions about the foods they eat. In the context of health care, information would enable consumers to identify coverage, caregivers, and medical practices that best suit their personal needs.

Information drives change in people and in markets.

Information influences people to change their behavior; for example, information on the quality of our environment—such as reports on air quality and power lines—helps people make judgments about where to live and what kinds of transportation to use. Information also creates pressure for the producers of goods and services to change. Food manufacturers, for instance, introduced entirely new lines of low-fat products in anticipation of consumers’ response to the nutritional information on existing products. Information on the quality of cars and trucks has reshaped the entire industry’s approach to designing, manufacturing, and selling vehicles.

In the health care industry, information is a crucial component of a long-term strategy to harness the power of informed consumers to reform the American health care system. The theory is that, armed with the right information and the ability to use it, consumers will reward the best health plans and providers and weed out those that perform inadequately. While the merits of this strategy are still debated, the true test of its impact cannot occur until consumers have the information they need and the tools to apply it.

Information separates myth from reality.

Finally, information punctures our fantasies and calms our fears. Thanks to daily stories in the media, Americans are flooded with information about health care with little help in sifting through it to find the nuggets of truth. We lack the solid grounding to make objective judgments about what we’re hearing. Maybe the local hospital is better than the academic medical center downtown. Maybe the care from one HMO is better than the care available elsewhere. Without objective information, we simply don’t know.

How This Site Can Help You "Talk"

It’s not easy to talk to consumers about health care quality. We can all tell stories about our own personal experiences with health care and convey our subjective impressions. But it is quite another challenge to sum up in an objective way what all these stories can tell us about the quality of health care: its appropriateness, its effectiveness, and its timeliness. The issues and the data are complex, confusing, and abstract. As a result, much of the information about quality that is currently available to consumers is hard to understand and even harder to apply to day-to-day decisions.

These are all reasons why you may want to look at the material in this Web site. If you’ve taken on the task of providing consumers with comparative information on health care quality, you’ll need help. This site will walk you through the decisions you have to make. We’ve pulled together and organized ideas and advice from experienced sponsors, respected researchers in the field, and experts in health communications. We’ve also combed through hundreds of examples to find the most innovative and effective approaches to conveying quality data. This site will also help you set reasonable goals for your information initiative. Educating consumers about health care quality will take time; getting them to change their behavior will take even longer.