Access to data on health care providers improves with PPACA

Do you have a personal physician? How did you choose your doctor?

Maybe you didn't choose, because you continue to use the family doctor who has served you for years. Or maybe you didn't see a need to establish a relationship with a personal physician.

Let's say it's time to find a doctor. How will you go about it? Will you:

* Google the doctor's name to find out about board-certification, years in practice, education, training, clinical quality and other factors?

* Ask for a recommendation from a trusted friend, neighbor, or family member?

Chances are, you'll ask a trusted friend, neighbor or family member for a recommendation. However, the Patient Protection and Affordable Care Act of 2010 lays the groundwork for improving consumer access to information on provider quality and effectiveness. PPACA mandates a national strategy to improve the delivery of health care services, including tying pay to performance for both hospitals and physicians.

 

Ready for homework?

But are consumers ready and willing to do their homework when it comes to choosing a health care provider? Do they know where to go for objective information and what criteria to use to measure quality?

The Robert Wood Johnson Foundation in Princeton, N.J., recently launched a new interactive website (www.rwjf.org/qualityequality/product.jsp?id=71857) that provides access to a repository of public reports for measuring the quality and cost of care physicians and hospitals provide.

As of this writing, there are 224 reports (197 state and 27 national) to access. Featuring a map of the United States, the tool shows users two icons for each state. One icon identifies the number of reports available for physicians; the other identifies the number of reports available for hospitals.

Let's say you live in northern New Jersey and need knee replacement surgery. Go to the site, click on "View these resources" and choose the "Doctors" icon - you'll be linked to the New Jersey Health Care Quality Institute.

Enter your search criteria - for example, New Jersey, Morristown, five miles, and orthopedic surgery - and select a physician from the list of results. You'll find information such as office location, gender, education, years since graduation, acceptable insurance, as well as patient satisfaction survey results.

Click on the "Learn more" link to see how the doctor ranks in volume for the procedures (s)he performs. You can also compare doctors by board certification, specialties and patient satisfaction ratings.

"The consistent finding that consumers prefer subjective information from friends and family about selecting doctors and hospitals to objective information about performance and outcomes shows how difficult it is to shift toward an evidence-based approach to making health care choices," wrote the authors of "Evidence That Consumers Are Skeptical About Evidence-Based Health Care," from a 2010 issue of Health Affairs.

 

Quality indicators needed to motivate consumers

The authors also noted that "employers, health care providers and policymakers need to position quality indicators into concepts and concrete activities that support and motivate consumers."

Should PPACA's individual mandate be found legal, such provider quality information is an essential next step, and intuitive websites such as RWJF's should be as familiar as Facebook so consumers can successfully choose health care providers.

 

Contributing Editor Leanne Fosbre, CEBS, is a senior summary plan description writer with HighRoads, an HR IT consulting company headquartered in Woburn, Mass. She partners with clients' vendors and legal counsel to create accurate, user-friendly and current summary plan documents. Fosbre is a certified employee benefits specialist and an ISCEBS Fellow. She can be reached at lfosbre@highroads.com.

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