A plan that performs poorly on all measures may not be interested in improving quality. There is an urgent need to improve the quality of health care in America, the prestigious Institute of Medicine, part of the National Academy of Sciences, noted last fall. There's an equally urgent need to improve the quality of health-care information. For most HMOs, no federal law requires disclosure of premiums, allowable charges, or the quality of care they provide. Some states do require plans to make some data public, but the quantity and quality of information varies from state to state.
Report cards have yet to produce clear and consistent information to guide consumers.
Satisfaction data that exist typically don't reflect the experiences of sick people who use the plan. If the marketplace is to work, information about plans must be available and truly useful. If such a group had teeth, it could go a long way toward making health plans give consumers what they need and requiring that report cards be meaningful. It also proposed that employers and government agencies that purchase health care establish a Forum for Health Care Quality, to measure health-care quality and to publicize standardized results. Plans to assemble the forum are underway.