Leapfrog California Healthcare Quality Report Card Evaluation of Consumer Decision Support Tools

The traditional patient—passive, uninformed and insulated from the true costs of care—is rapidly being replaced by a new health care consumer. This new consumer has access to health information and a desire to participate in decisions. The engaged consumer can potentially transform health care by demanding reliable information on quality and by choosing quality providers to meet individual health needs. The Pacific Business Group on Health encourages the emergence of the new consumer by driving public reporting of useful quality information for decision-making at all levels of care.

PBGH seeks to promote consumer engagement both directly and indirectly. By making information directly available through PBGH members, and by providing the expertise behind the Office of the Patient Advocate Report Card Web site, PBGH strives to make accessible practical, relevant information on health care. Information from the Leapfrog California patient safety initiative conveys effective messages on avoidable medical errors and helps consumers choose the safest hospitals. These initiatives benefit PBGH member employees, retirees and their families as well as all California consumers.

PBGH advances the science of consumer reporting. A number of initiatives to evaluate website and consumer tools have informed purchaser decisions and promoted marketplace improvements. In April, 2007, PBGH hosted a symposium for purchasers and industry stakeholders to showcase work in progress at that time. The initiative resulted in a comprehensive assessment of treatment option support tools, hospital choice tools, and personal cost decision support tools.

The consumer engagement activities are designed to influence consumer decision-making at all levels of care—from health plan to physicians and medical groups to hospital. Examples of these efforts include:

• Medical Groups and Physicians: PBGH and Members promote advancements in provider performance reporting through work with the Integrated Healthcare Associations Pay-For-Performance project and through ground-breaking Physician Measurement efforts. The latter includes designation as one of six national pilots to work with Centers for Medicare & Medicaid Services (CMS) and the AQA Alliance to pilot the collection and reporting of physician-level performance information.  Read more.
• Hospitals: The Leapfrog Patient Safety Initiative is focused on encouraging consumer decision-making at the hospital level. Health plans have played an important role in encouraging hospitals to participate in this effort, and doctors will have a key role in advising their patient's on hospital choice. PBGH is also working with others at the national level, including the National Quality Forum, to identify additional hospital quality metrics for public reporting and to assess tiered networks.
• Health Plans/Medical Groups: The California Healthcare Quality Report Card provides standardized, comparative information on health plans to a much wider consumer population than ever through a Web-based and print report. Since 2001, PBGH has served as a vendor, providing technical expertise and helping the Office of the Patient Advocate build on existing tested measures rather than start from scratch.

Evaluation of Consumer Decision Support Tools

Consumer engagement in decisions about coverage, provider and treatment choices, and purchasing is central to the value-purchasing and benefit design strategies of large employers. PBGH seeks to advance breakthroughs in use of consumer tools, resources and performance information. The goal is to influence employees’ value-based decision making and participation in managing their personal health. With support from the California HealthCare Foundation, PBGH assessed three types of consumer decision support tools sponsored by health plans, employers, or other third parties:

• Treatment option support;
• Hospital choice; and
• Personal cost decision support.

A conference summary captures a high-level overview of the project and discussion by leading experts. The report delineates the assessment methodology, evaluation framework, and key features of leading online consumer decision support tools to inform the development and enhancement of additional Web-based services.