A field experiment on the impact of physician-level performance data on consumers' choice of physician

Abstract

Background: In 2008, HealthPlus of Michigan introduced an online primary care provider (PCP) report that displays clinical quality data and patients' ratings of their experiences with PCPs on a public web site.

Design and procedure: A randomized encouragement design was used to examine the impact of HealthPlus's online physician-quality report on new plan members' choice of a PCP. This study evaluated the impact of an added encouragement to utilize the report by randomizing half of new adult plan members in 2009-2010, who were required to select a PCP (N=1347), to receive a 1-page letter signed by the health plan's chief medical officer emphasizing the importance of the online report and a brief phone call reminder. We examined the use of the report and the quality of PCPs selected by participants.

Results: Twenty-eight percent of participants in the encouragement condition versus 22% in the control condition looked at the online report before selecting a PCP. Although participants in the encouragement condition selected PCPs with higher patient experience ratings than did control participants, this difference was not explained by their increased likelihood of accessing the online report.

Conclusions: Health plan members can be encouraged successfully to access physician-level quality data using an inexpensive letter and automated phone call. However, a large proportion of missing data in HealthPlus's online report may have limited the influence of the physician-quality report on consumer choice.

Figure 1

Number (percentage) of new plan enrollees assigned to the control and encouragement conditions who returned a completed survey and the number (percentage) of survey respondents and non-respondents in each condition who selected a primary care provider within a year of enrollment.