VITAL EVIDENCE

VITAL EVIDENCE

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Thursday, February 16, 2006

Taking Patients' Word May Be Ill-Advised

In their quest for better health care, America's seniors have been scrutinizing report cards that grade Medicare's managed-care plans. But researchers worry that patients are being enticed by fancy waiting rooms, friendly receptionists and convenient parking garages rather than the best care providers.

That's based on an analysis by the National Bureau of Economic Research that suggests patients may be acting upon the least useful information, namely consumer satisfaction scores.

Although the report cards include health quality data, such as how many women in a plan received mammograms or whether diabetics were receiving proper eye care, patients' feedback had the most impact on future sign-ups.

"It is surprising that satisfaction scores were included at all, and potentially disconcerting that consumers ignored an alternative, objective measure of quality that was also provided," the authors wrote.

The consumer ratings "show people what other people like them think about a provider," Medicare spokesman Peter Ashkenaz said.

By basing enrollment decisions largely on patient satisfaction scores, Medicare beneficiaries are essentially relying on "the aggregation of everybody's best guess," said Leemore Dafny, an assistant professor at Northwestern University's Kellogg Graduate School of Management. "These are amenities that probably don't have any long-term health effects on patients. They may affect their satisfaction but probably not their health."

But Joseph Newhouse of Harvard University said customer satisfaction reports shouldn't be dismissed. It is the patients, he pointed out, who know whether they have received the tests and treatments they need.

Seniors who do want more information can log on to the Web site Medicare.gov.

-- Ceci Connolly


© 2006 The Washington Post Company

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