Health care report cards: will they make the grade?
"Outcomes data are meaningless or misleading unless they are adjusted for severity of illness, presence of comorbidities, documentation of advance directives, and other factors not under the control of providers," observes Ohio State University Professor Timothy Jost, JD. Health care analysts also contend that the time that is required to analyze, complete, and report data can lessen the value of those data. Currently, health care report cards often require several years to produce. Hence, the data that are reported may not accurately reflect a health plan's or other provider's current performance, which can be affected by changes implemented since the data were collected. Also, some experts question the value and wisdom of giving report cards to consumers, who may not understand what the reports are measuring. As UHC official Sheila Leatherman summarizes: "There is no agreement about who should receive the data, in what format, and with what kinds of interpretative materials." "Physicians and others who utilize health care report cards need to be aware of their limitations," summarizes Don Nielsen, MD, associate medical director and quality consultant with Kaiser Permanente. However, the burgeoning efforts at national, state, and community levels to develop report cards should not be ignored, he says. Dr. Nielsen recommends that surgeons and other physicians work with health plans and other entities that are developing report cards to identify limitations in health care measures and data systems and to create better measures of provider performance.
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