Trend: Going For High-Value Providers

The Health and Human Services‘ Agency for Healthcare Research and Quality (AHRQ) has released its study of consumers and their health care provider decisions.  It was designed to answer one of life’s eternal questions: what do people want?

What did the AHRQ discover?

Surprise, surprise!  We consumers tend to equate cost with quality, whatever we are buying.  In terms of health care providers, when asked to select a provider based strictly on cost, we invariably choose the more expensive option.  We want real value for our money, then.  We worry that lower cost means lower quality care.  Period.

Again, this is hardly an unexpected conclusion.  Deep down, of course, we all know that price alone does not guarantee quality.  Higher costs could be attributed to superfluous or unnecessary services or poorly run  or out-of-touch organizations, lots of things actually.  So cost information by itself does not help us get the best value for our health care money.

Show us the right stuff, though, talk to us about price and quality, now that changes everything.  The study found that when we are given more to go on – when we could compare and contrast services and doctors and facilities – we opt for high-value providers, providers who deliver high quality care at a lower cost.

Here’s the next trick.  How do we best get that information, price and quality together?  There has been very little scientific evidence to guide this aspect of the challenge.  Health care professionals are still sorting out how to present health care provider information to us in a user-friendly, appropriate and meaningful format.

In fact, a team of researchers recently studied some 1,400 employees in a randomized experiment to see just how they responded to a variety of presentations of cost and quality information.  When providers were clearly identified as high quality, according to the study results, cost and price had markedly less influence on the decision-making.  Under these circumstances, the consumer was likely to go for a provider who cost less without losing quality.  According to AHRQ Director Carolyn M. Clancy, MD

This study has important implications for the more than 150 public reports on physicians and hospital care….It’s not simply a question of providing information on cost, but providing it in a way that is integrated with quality scores.

Now, of course, comes the business of ‘quality scores’.  How does that work?

The study looked at all kinds of ways to effectively (and simply) present cost and quality information.  They tried using symbols – dollars signs ($) and stars (**) – along with specifics such as dollar amounts and percentages, and labels: ‘better’ or ‘appropriate use’.  The consumers surveyed were smart enough to find value when clear, unambiguous information was available.  Further, a check mark (√) next to ‘high-value’ provider, coupled with clear cost and quality information, guided consumers towards higher value options.  The stronger the quality signals, the more confident the consumers in their decisions and choices.

All of this will be used to design a sort of public report card, a way to offer consumers timely, comprehensible information about the quality and cost of the various health care providers competing for our custom.  And do we ever need it!  Despite what they’ve been claiming, most of the summaries and reports insurance providers send us are still loaded with unfriendly insurance-speak, insider buzzwords and jargon, and spreadsheets and comparison tools only a Sheldon Cooper could love.  It’s simply not enough to send us summaries of benefits per the Affordable Care Act.  We’ve got to be able to read and understand the darned things!

We’ll keep you posted.