consumers' attitudes toward report cards. The work included a review of the literature and focus groups with a broad range of consumers.

This work and our review of summaries of focus groups conducted by other groups lead to several general conclusions:

  • Consumers would use information on how a plan works, what it costs, the covered benefits, the quality of care, and overall satisfaction with care if it were available.
  • Consumers are most concerned about costs of coverage, technical competence, the information and communication provided by physicians, coordination of care, and access.
  • Consumers are savvy and are able to evaluate critically information about quality. In fact, they raise many of the same issues debated by experts in quality measurement. Every single focus group expressed concern, for example, about the source and quality of the data, the size of the population (denominator), the size of the survey sample, and the validity of the data.
  • Consumers want to know how others "like them" evaluate care, and many trust patient evaluations more than any other source of data. Opinions about the appropriate balance between summary and detailed information varied.
  • Consumers want an unbiased, expert source of judgment about health care quality. Many are skeptical about data collection or assessments performed by health plans, insurance companies, employers, and/or the government.

What Kind of Information is of Particular Interest to Medicare Beneficiaries?

We have only limited data about how Medicare beneficiaries make decisions to join managed care plans and their needs for information to support those decisions. However, several organizations have conducted focus groups with Medicare beneficiaries about related issues that provide us with some insights, and inferences can be made about the kind of information that Medicare beneficiaries would want about managed care. We also conducted interviews with Medicare program managers in large managed care organizations, state insurance hot lines, and con-



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