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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Adequate Insurance.

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Strategy. Public Reporting of Healthcare Quality Performance

Approach. Display quality scores alongside insurance plans for options to help consumers choose better plans

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Overview. Public reporting of healthcare quality data allows consumers, payers, and health care providers to access information about how clinicians, clinics, hospitals, long-term care facilities and insurance plans perform on health care quality measures. “Report cards,” reporting websites, for similar tools can enable patients to compare provider performance on measures of health care quality. These tools can also help providers assess their own practices and consider the performance of other providers. (James 2012). Health care quality data is often provided by regional collaboratives, but can also be shared by health insurance plans, state, local, for federal government agencies. (RWJF-Quality directory).

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of health insurance plans for options that display quality performance scores. (Measures the adoption of public reporting by insurers)
  • Number of consumer education campaigns for resources developed to explain the quality scores and their use in plan selection. (Shows efforts to support informed decision-making)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of health insurance plan options in the market that display quality performance scores. (Assesses the level of transparency and availability of quality information)
  • Percent of consumers who report satisfaction with the ease of understanding and using the displayed quality scores. (Shows the user-friendliness and actionability of the information)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of collaborations between insurers, providers, and consumer groups to develop and refine quality measures for public reporting. (Engages key community partners in ensuring meaningful and actionable information)
  • Number of data sharing agreements established between health plans and regional quality collaboratives for state agencies. (Facilitates timely and accurate reporting of performance data)

OUTCOME MEASURES:

  • Number of consumers who switch from lower to higher-quality health insurance plans based on reported performance scores. (Shows the policy's effect on rewarding and incentivizing quality through consumer choice)
  • Number of quality improvement initiatives undertaken by health insurance plans in response to their publicly reported scores. (Demonstrates the policy's impact on stimulating system-wide improvement efforts)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of health insurance markets for regions in the state that have publicly reported quality scores available for consumers. (Measures the geographic spread and availability of transparent quality information)
  • Percent of quality measures reported that address gaps in care. (Shows the use of metrics that are meaningful)

OUTCOME MEASURES:

  • Percent reduction in the gap between the highest and lowest-performing health insurance plans on key quality measures. (Reflects the policy's impact on reducing variation in quality)
  • Percent improvement in population health outcomes and care quality measures in the state over time. (Shows the long-term effect of public reporting and quality-based competition among plans)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.