Why Do So Few Consumers Use Health Care Quality Report Cards? A Framework for Understanding the Limited Consumer Impact of Comparative Quality Information

Abstract

Despite growing investment in producing and releasing comparative provider quality information (CQI), consumer use of CQI has remained poor. We offer a framework to interpret and synthesize the existing literature’s diverse approaches to explaining the CQI’s low appeal for consumers. Our framework cautions CQI stakeholders against forming unrealistic expectations of pervasive consumer use and suggests that they focus their efforts more narrowly on consumers who may find CQI more salient for choosing providers. We review the consumer impact of stakeholder efforts to apply the burgeoning knowledge of consumers’ cognitive limitations to the design and dissemination of the new generation of report cards; we conclude that while it is too limited to draw firm conclusions, early evidence suggests consumers are responding to the novel design and dissemination strategies. We find that consumers continue to have difficulty accessing reliable report cards, while the media remains underused in the dissemination of report cards.