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OPINION: Data on physician quality needs an upgrade

December 29, 2013 - 6:00am


The drive toward consumerism in the health insurance sector is hitting a troublesome roadblock in the form of poor information on physician quality. And that lack of information on physician quality is a hindrance to health care cost control efforts that will only be exacerbated by the flood of newly insured patients coming into the system via the health care reform law.

As we report on page 3, most states fail to provide health care consumers with the information they need to make informed judgments about the physicians they should consider using. That failure to provide adequate information is taking place in an era when patients are being incentivized to spend health care dollars wisely and differentiate between doctors based on value for money.

It's not a lack of data that is causing the problem. Rather, the data that is available often is not organized appropriately for patients and their employers to easily access.

While there are numerous organizations that assess physician quality, the information can appear contradictory or incomplete and the task of deciphering the data is daunting for employer organizations, leave alone individual employees.

The problem, however, would only be partially alleviated by better data organization. The data sets themselves often focus on process rather than outcomes. Such a focus may tell an observer that the physician is following recommended guidelines, but it says little about whether a patient's condition actually improves — which surely is the ultimate measure of a physician's performance.

The good news is that efforts are being made to introduce a greater focus on outcomes in measuring physician quality. In addition, a few states, most notably Minnesota and Washington, are receiving top grades for the quality information they make available. The fact that a few states can provide consumers and employers with information to help them make informed decisions when selecting physicians shows that the problem is not insurmountable.

As employers search for ways to provide good-quality health care options at a time when medical costs continue to rise above the rate of inflation, however, the whole of the health care establishment and the organizations that measure their quality need to work faster to provide consumers with the tools they need to make informed decisions.