QUALITY CARE: GAO Finds Plans Holding Back Information
Public and private health care purchasers, examined in a recent federal government study, only complied with about half of the information disclosure recommendations made by a presidentially appointed quality care panel. In reaction to mounting "public concern about health care quality," President Clinton charged the Advisory Commission on Consumer Protection and Quality in the Health Care Industry with developing standards for information disclosure that would allow patients to make informed choices about the health care they choose. The General Accounting Office report outlined the response by insurers to the Consumer Bill of Rights submitted by the commission last fall. But in its review of nine large public and private health care purchasers, a purchasing coalition and a business group, the GAO found that "information that the commission recommended be provided about the business relationships and financial arrangements among health professionals, health care facilities and health plans" is not routinely being reported to health care consumers.
While the report found that health plans are providing information on covered benefits and cost-sharing -- information typically provided to consumers -- it found that patients had less access to information about health providers and facilities than they did about the health plans themselves. In fact, the GAO reports that "the areas of greatest difference between the commission recommendations ... and that which is currently available to consumers involved characteristics of health professionals and health care facilities." Information about physician compensation arrangements -- "including financial incentives for physicians to be conservative in providing services" -- were not provided by any of the groups that the GAO reviewed. The report further found that the surveyed groups did not adhere to the commission's recommendations on information dissemination in its distribution of "data on service performance, complaint filing and resolution procedures, availability of translation or interpretation services, number and credentials of providers of direct patient care, and whether a facility has been excluded from any federal health program" (GAO report 98-137). Click here for a PDF version of the GAO study.