Module 4: Public Reporting

Your Goals in This Inquiry

• Identify existing public reporting efforts, resources, and expertise. This includes public reporting at the delivery system level (e.g., clinic/practice location, physician group, physician, hospital).
• Identify range of providers (hospital, physician, nursing home) for which report cards exist and the adequacy of these efforts from different perspectives.
• For quality measures, delineate public reporting of clinical quality measures as well as patient experience of care measures. Include public reporting of efficiency/cost measures.
• Identify the level of interest, and who is interested, in standard report cards/public reporting.
• Identify how to make public reporting more meaningful and useful to consumers.
• Identify potential areas of initial implementation, coordination, or expansion of public reporting.
• Consider integration and reporting of data from the Centers for Medicare & Medicaid Services (CMS) and the Brookings Institution (commercial health plan data) in your community's public reporting plan.

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Information You May Want to Gather

• Existing local public reporting of provider cost and quality by states, health plans, and other organizations.
• Existing public reporting by purchasers including employers and Medicaid.
• Existing public reporting by health plans, employers, and others — where reports are available only to constituency groups such as members, employees/families.
• Official positions or recommendations of professional organizations related to public reporting.
• Existing Hospital Compare results (http://www.hospitalcompare.hhs.gov/).
• Dartmouth Atlas (http://www.dartmouthatlas.org).
• https://talkingquality.ahrq.gov, a searchable database of public reports.
• National reporting by Leapfrog (http://www.leapfroggroup.org), NCQA http://recognition.ncqa.org, others.

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Key Individuals to Contact

• Health plans that have publicly reported, or reported to their members, provider performance or tiered providers.
• Physician and hospital leaders who are measuring and publicly reporting their performance or measuring and not yet reporting publicly.
• Local hospital and medical associations that have public positions related to public reporting.
• Public purchasers (states, counties, cities), Medicaid, employer leaders or business coalitions that have advocated for public reporting.
• Consumer advocacy organizations involved in health or health care.
• Quality improvement organizations (QIOs) with experience gathering and reporting data from community providers, either publicly or privately.
• State data organizations such as your state health department or hospital/health system association.

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Other Individuals to Consider Contacting

• Labor.
• Academia, researchers.
• Public health agencies.

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Suggested Questions

Communitywide Public Reporting

• What activities or discussions have taken place in this community related to public reporting?
• Who are the key players, both organizations and individuals including drivers and resistors of public reporting?
• What has been reported publicly from locally supported and nationally developed measures in this community so far and what are the lessons learned?
• How would you describe the quality and credibility of the public reporting available in your area?
• What is the level of interest and support in using nationally endorsed measures and measure specifications and what are the pros and cons?
• What is the level of interest in aggregating data from various sources (e.g., health plans, third party administrators, employers, to develop provider specific report cards)?
• Who are the primary users, intended and actual, of the information?
• What is the evidence that the information is presented in a consumer-friendly, highly usable format?
• Is there interest in hosting a community portal that provides access to all public reporting?
• Who are the key leaders, advocates, and opponents of public reporting in this community?
• If applicable, how would you ensure that rural areas and small physician practices are included in public reporting activities?
• Are there geographic issues, such as distances, market service areas, local jurisdictions, or other boundaries, that may pose challenges to public reporting?
• Are there demographic issues such as age, income, education levels, language, or ethnicity that need to be considered?
• Do you see any dominant organization or stakeholder, for example, purchasers, providers, or health plans, that might impede or support the Community Quality Collaborative's public reporting goals?
• How do you anticipate recruiting and supporting consumer representatives in public reporting?

Stakeholder-Specific Public Reporting

• What initiatives have you undertaken related to public reporting?
• What are your current activities?
• What are your goals and plans for the future?
• Who is involved? How should they be involved in the Community Quality Collaborative?

Future Community Quality Collaborative Measurement Activities

• What could your organization contribute to the Community Quality Collaborative? How do you envision being involved in the goals of the Community Quality Collaborative?
• How do you see the Community Quality Collaborative potentially using the data from CMS and Brookings Institution for public reporting?
• What challenges or obstacles do you anticipate for the Community Quality Collaborative in meeting public reporting goals?
• What strengths and opportunities do you see for the Community Quality Collaborative in meeting these goals?

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Compiling Results

Tracking your activities and results of your inventory in a table similar to the one below will be useful for reporting activities to the Leadership Team.

Public Reporting — Activities and Results
Interviewee Name	Position, Organization	Summary	Conclusions/Next Steps

After data have been gathered from all sources in the focus area, the Focus Area Team Leader and members may analyze the results by reviewing the goals identified at the beginning of this section and by identifying and summarizing the following aspects of the inventory findings with each other and with other Focus Area Team Leaders.

Public Reporting — Analysis
Gaps
Overlaps
Opportunities for Alignment
Challenges
Lessons Learned
Resources
Leaders

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Consensus Score Card

You may wish to develop a score for your Community Quality Collaborative's stage of development in each focus area to facilitate comparison of its stage of development across focus areas. You may discover differences in scores of individual key stakeholders for the same question. Identifying the degree of consensus among stakeholders will be useful in clarifying differing perceptions and goals and areas where consensus building may be useful for more effective collaboration.

If a quantitative approach doesn't fit in your situation, you may wish to use a more qualitative approach such as identifying areas of strengths and weaknesses or specific challenges and solutions.

• Ask each team member to answer the following questions on a scale of 1-10 with 1 being the least developed and 10 being the most developed.
• Average the scores of the team members, for each question, to get an average score per question.
• Discuss any major differences between team members' scores to gain an understanding of each other's perspectives and knowledge.
• Total the scores for all the questions and divide by the number of questions to get the score for this focus area.
• Compare your Community Quality Collaborative's strength in this focus area to its strength in other focus areas in the overall Community Inventory Consensus Score Card when compiling and analyzing overall results from the tool.

Public Reporting Consensus Score Card	SCORE (1-10)
1. Our community reports cost information on hospitals publicly.
2. Our community reports quality information on hospitals publicly.
3. Our community reports cost information on physicians publicly.
4. Our community reports quality information on physicians publicly.
5. Health care leaders in our community support public reporting.
6. Our community has evidence that public reports have been promoted in an effective manner.
7. The existing public reporting efforts involve the Community Quality Collaborative stakeholders: purchasers, plans, providers, and consumers.
8. The Community Quality Collaborative includes the right stakeholders to accomplish public reporting goals.
9. The Community Quality Collaborative includes the right individuals to accomplish public reporting goals.
10. The individuals at the table are willing and able to advocate on behalf of public reporting goals in their respective organizations.
11. Members of the Community Quality Collaborative share a common vision of its public reporting goals.
12. The information reported publicly is viewed as credible and accurate by providers.
13. Publicly reported information is widely used by consumers.
14. The organizations involved in the Community Quality Collaborative are willing to share resources, knowledge, expertise, and support the Community Quality Collaborative's public reporting goals.
15. There are sufficient resources for the Community Quality Collaborative to meet its public reporting goals.
16. The participants involved will devote adequate time and resources to the public reporting goals.
17. The Community Quality Collaborative will seek outside expertise if necessary to achieve its public reporting goals.
18. The Community Quality Collaborative will be able to develop a strategy and plan on how to use the data from CMS and Brookings Institution for public reporting.
Total Score

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