Making A Consumer-Healthcare Connection

Giving consumers information and data on providers’ quality of care and clinical results is one important path to enhanced transparency, patient engagement, and better health care.     

Two publications out this month add significantly to the dialogue on this issue.  The journal Health Affairs devotes most of its April issue to the theme of “patients’ and consumers’ use of evidence to inform health care decisions.”  And the cover story in the May issue of Consumer Reports is entitled “What You Don’t Know About Your Doctor Could Hurt You.”  

Among observations in the Health Affairs papers: 

• Getting consumers to consider quality and cost (and the concept of value) remains a challenge.  A survey of some 2,000 people found that most don’t think cost and quality of care are necessarily related.   That’s good and bad.  Good because previously published research indicated that most people leaned to believing that higher price means better quality.   Bad because the new survey signals that people are still disconnected from pursuing value in healthcare.   

• Yelp reviews of hospitals by consumers track closely with reviews from patients as assessed by the more elaborate and costly Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).   Moreover, the researchers conclude that the Yelp reviews allowed consumers to raise issues that clearly seemed more salient to them than the HCAHPS. 

• Websites that allow consumers to review hospitals and doctors have far more traffic than sites presenting provider ratings based on quality metrics and patient experience as assessed by the CAHPS tools.  For example, Healthgrades had about 8 million unique visitors per month in late 2015.  By comparison, the California Health Care Foundation’s provider rating site CalQualityCare.org had 174,000 unique visitors in the year Oct. 2014 to Oct. 2015. We need to leverage the popularity of consumer review sites such as Yelp and Healthgrades to bring awareness and traffic to sites based on quality metrics, in part by melding the two approaches over time.    

• Price comparison tools are still a work on progress.  One study, for example, found that just 3.5% of Aetna enrollees who had access to a price comparison tool used it. 

Consumer Reports has a different take on physician quality of care, and consumers’ right to know.  Its’ article probes the failure of government and the profession itself to stop bad or troubled doctors from practicing medicine, even after they’ve been caught. 

It’s a penetrating and sobering account.  In one case, a California OBGYN named Leonard Kurian, M.D., was found culpable after removing the wrong diseased ovary from a 37-year-old woman.  In addition, the California Medical Board found that Kurian likely contributed to the deaths of two young mothers who had recently given birth to healthy babies. 

Was his license revoked or suspended?  No.  The board placed him on probation from 2015 until 2022. 

In the fall of 2015, Consumer Reports’ advocacy wing petitioned the California Medical Board to require doctors like Kurian to tell patients of their status.  The board rejected the idea, saying it would put too much of a burden on doctors and damage the doctor-patient relationship.   Consumer Reports obtained California’s database of doctors on probation as of September 2015.  That information is now searchable on Consumer Reports’ Safe Patient Project website.      

Also, the Affordable Care Act mandated Physician Compare, a website now under development that will eventually present physician ratings based on the MACRA measurement scheme.   

Even so, as the Health Affairs papers and Consumers Reports article underscore, it remains a challenge to nurture full transparency in health care and present meaningful data to consumers—information they can understand and base their choices on.  Both must become a bigger priority in the years to come.

Steven Findlay is an independent healthcare journalist and a contributing editor for Consumer Reports. A version of this article originally appeared on The Health Care Blog.