Report cards on health care plans and providers have become common because it is hoped consumers who have access to information on quality will make good choices, leading to better financial and health outcomes. This article synthesizes a broad span of studies since 1997 that examine the link between quality and choice, and the extent to which providing consumers with more information on quality influences their health care decisions. This review finds people do opt for higher quality choices; but this varies by population group and the effect of report cards may be small.
The article cites more than 75 references from medical, economics and health services literature. Despite that breadth, the authors conclude there are many unanswered questions. There are too many gaps in the existing literature to determine whether providing information about plan and provider quality will prompt consumers generally to make better choices in the marketplace, nor is it clear how and when to release information to have the greatest impact on consumer choice. The authors further worry that even the study results observed so far may not be valid in an environment where consumers are asked to pay substantially more for health care as they may be in the future.