Nearly one-third of Americans are intolerant of inaccuracy greater than 5 percent when it comes to physician performance ratings, a new study by the Center for Studying Health System Change suggests.
According to Matthew Davis, MD, HSC senior researcher and coauthor of the study, the findings raise a question as to whether healthcare plans should publicly report the level of accuracy in their performance measurements.
"Major limitations in readily available clinical data sources and resulting performance measures make it likely that error in most individual physician ratings exceeds 5 percent," Davis said.
The conundrum raised by the study is whether healthcare plans should explain the complexities associated with interpreting data and if in so doing they will lose consumer trust. "If a substantial proportion of consumers decline to respond to ratings, plans and provider leaders will need to improve the accuracy of ratings or consider other means of trying to improve care," Davis said.
"Despite the variation, consumers' willingness to tolerate inaccurate ratings is likely much higher than physicians', possibly because consumers see flawed information as preferable to no information at all, while physicians are justifiably concerned that inaccurate ratings will jeopardize their reputations and livelihoods," Davis said.
The study, titled "Consumer Tolerance for Inaccuracy in Physician Performance Ratings: One Size Fits None," was based on a nationally representative survey of 1,057 adults aged 18 years and older and was conducted Dec. 14-18, 2006.
The survey measured consumer acceptance for measurement error in physician performance ratings for four applications: releasing ratings to the general public, using ratings to choose one's own primary care physician, using ratings to vary physicians' payment rates based on performance, and using ratings to encourage consumers to seek care from more highly rated physicians via tiered-benefit plans.
The most common response for each application of physician performance ratings was low tolerance for inaccuracy. More than 20 percent of consumers, however, reported being comfortable with inaccuracy of 20 percent, the study said.
Consumers were most intolerant of inaccuracy when data is to be used for selecting a personal physician or for when insurance plans will pay physicians differently based on performance ratings, findings showed.
Paul B. Ginsburg, president of HSC, said the study is significant because, "as doctors and health plans spar over the accuracy of fledgling physician performance rating programs, consumer views about accuracy have been absent from the debate until now."