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Informed consumers can play a vital role in improving health care quality

Today's consumers can consult a growing body of information on health plan quality and report cards to choose a health plan. However, it's not clear to what extent consumers take advantage of this information in making health plan choices. What's more, a focus on health plan choice in isolation from other important aspects of consumers' involvement with health care decisions puts all stakeholders at risk of losing critical information needed to improve health care quality.

Consumers must be engaged as vital participants and stakeholders in health care delivery and not just as passive recipients of information or intermittent evaluators. The challenge is to use the full power of informed consumers to drive health care improvements, says Carolyn M. Clancy, M.D., of the Agency for Healthcare Research and Quality, in a recent editorial.

In her editorial, Dr. Clancy comments on a study by Booske, Sainfort, and Hundt (in the same journal, pp. 839-854) that examined reasons for the health plan choices of 200 randomly selected Wisconsin State employees close to the annual "open season" period. Health plan cost and extent of coverage tended to dominate consumers' health plan choices. However, when individuals were asked to add another attribute, most chose quality. After reviewing information including consumer satisfaction ratings and other indicators, the number of people citing quality as an important feature increased by almost 40 percent. Using a predetermined list of criteria, these workers assigned the highest weights to quality of care, closely followed by extent of coverage, which is consistent with prior studies.

These findings support a "glass half full" view of consumers' use of information about quality to inform their choices of health plans, concludes Dr. Clancy. Optimists can argue that increased exposure to and understanding of health plan assessments based on clinical quality measures and consumers' ratings of plans are likely to play a more important role in consumers' choices in the future. On the other hand, skeptics can argue that this was a highly educated group with prior "open season" experience and use of personal computers, and thus their choices may not mirror those of the general population.

More details are in "Consumer preferences: Path to improvement?" by Dr. Clancy in the October 1999 Health Services Research 34(4), pp. 807-811. Reprints (AHRQ Publication No. 00-R002) are available from the AHRQ Clearinghouse.

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