Finding Quality Information

by US Department of Health and Human Services

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Today, you can find a great deal of information about health care quality, both online and in print. New tools and resources for assessing and improving health care quality are being developed and will be available soon.

Meanwhile, here is a brief look at what is available now.

Report Cards

Reports cards and other quality reports include consumer ratings, clinical performance measures, or both. They can help you select the right treatment and the right health care provider based on what is most important to you. You may be able to get quality reports from:

• Your employer: Ask your personnel office for information on health plans.

• Health plans: Ask the plan's customer service office about quality reports.

• Other health care providers: Hospitals, nursing homes, and community health clinics may have quality reports.

Several government agencies publish quality reports and other types of quality information.

• For example, the U.S. Department of Health and Human Services has a quality tool that helps you compare the care provided by hospitals in your area. This tool is available online at http://www.hospitalcompare.hhs.gov.

• Another Web site (http://www.medicare.gov/NHCompare/home.asp) provided by the Centers for Medicare & Medicaid Services has detailed information on the past performance of every Medicare- and Medicaid-certified nursing home in the country.

Accreditation

Accreditation is another indicator that can be used to judge quality. Accreditation is a "seal of approval" given by a private, independent group. Health care organizations - such as hospitals - must meet national standards, including clinical performance measures, in order to be accredited. Select for a list of organizations that award accreditation.

Accreditation reports present quality information on hospitals, nursing homes, and other health care facilities. For example, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) prepares a performance report on each hospital that it surveys. Another group, the National Committee for Quality Assurance (NCQA), rates health plans like HMOs. NCQA's Health Plan Report Card presents accreditation results for hundreds of health plans across the country.

If you need help in finding quality reports, accreditation reports, or other types of quality information, check with your local library or your local or State health department. You can find your State health department listed in the blue pages of your phone book.

Consumer Ratings

Consumer ratings tell you what other people like you think about their health care. Some consumer ratings focus on health plans. For example, a survey called CAHPS® asks people about the quality of care in their own health plans. Their answers can help you decide whether you want to join one of those plans.

Hospital CAHPS (HCAHPS®) will be released for the first time in 2006. It will ask patients about their experiences with hospital care.

Choosing Quality Health Care

Here are some tips for making quality a key factor in the health care decisions you make about health plans, doctors, treatments, hospitals, and long-term care.

Look for a health plan that:

• Has been given high ratings by its members on the things that are important to you.
• Has the doctors and hospitals you want or need.
• Provides the benefits (covered services) you need.
• Provides services where and when you need them.
• Has a documented history of doing a good job of preventing and treating illness.

Look for a doctor who:

• Has received high ratings for quality of care.
• Has the training and experience to meet your needs.
• Will work with you to make decisions about your health care.

If you become ill, make sure you understand:

• Your diagnosis.
• How soon you need to be treated.
• Your treatment choices, including the benefits and risks of each treatment.
• How much experience your doctor has in treating your condition.

Look for a hospital that:

• Is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
• Is rated highly by the State and by consumer groups or other organizations.
• Has a lot of experience and success in treating your condition.
• Monitors quality of care and works to improve quality.

In choosing a nursing home or other long-term care facility, look for one that:

• Has been found by State agencies and other groups to provide quality care.
• Provides a level of care, including staff and services, that will meet your needs.

Moving Forward with Quality Improvement

The National Healthcare Quality Report and the National Healthcare Disparities Report present important information about the state of health care in America. These reports indicate that:

• Quality is improving in many areas, but change takes time.
• The gap between the best possible care and actual care remains large.
• Quality of care varies widely across the country.
• Continuing improvement in health care is possible.

People like you have an important role to play in health care quality improvement. You can use the measures described in this booklet as a yardstick to assess the quality of care provided to you and your family members.

In addition, many public and private groups are working to improve health care quality measures and other quality tools. The goal is to make these measures and tools reliable, uniform, and helpful to consumers and patients in making health care choices.

About the Author

The Department of Health & Human Services is the United States government's principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. The department includes more than 300 programs, covering a wide spectrum of activities.