Public Interest in the Use of Quality Metrics in Healthcare Is Mixed — Unless It Allows Them to Reduce Their Health Insurance Costs

ROCHESTER, N.Y. – May 24, 2005 – A new survey shows that the U.S. public is only modestly supportive of having health plans pay more to doctors if they have been shown to provide higher quality care to their patients. However, a sizable majority is interested in this type of plan if it helps to lower their health insurance coverage costs. The question remains: how should health plans measure quality? On the whole, the public is somewhat supportive of measures that are associated with prevention and promoting patient compliance while they are less supportive of plans that measure quality based on particular technology metrics.

These are some of the results of a Harris Interactive^® online survey of 2,129 U.S. adults conducted between May 11 and 13, 2005 for The Wall Street Journal Online’s Health Industry Edition.

Nearly two in five (38%) adults strongly or somewhat support having health insurance plans pay more to doctors if they have been shown to provide higher quality care to their patients. A further 17 percent oppose a pay-for-performance system and a third (32%) is indifferent, neither favoring nor opposing one. Interestingly, the more educated adults are, the more likely they are to favor a pay-for-performance system.

Public support for a pay-for-performance system increases dramatically if it helps to lower their costs. Two-thirds (67%) of adults are interested in a health insurance plan that provides access to fewer doctors, but certifies that those doctors provide higher quality care to their patients and charges consumers lower premium, deductible and co-payment charges.

The public seems to be supportive of certain metrics more than others that health insurance plans might use to judge the quality of care doctors provide to their patients. Metrics supported by more of the public include:

• Whether the doctor uses preventive tests like cancer screening and blood tests for high cholesterol (64%)
• Patient satisfaction surveys (57%)
• Whether the doctor uses reminder systems to prompt patients to get needed follow-up care (50%)
• Whether the doctor uses standardized guidelines to monitor the health of patients with chronic conditions like asthma and diabetes (47%)
• Whether the doctor prescribed generics rather than prescription drugs when generics are available (47%)
• Whether the doctor enrolls patients with chronic conditions like asthma and diabetes into disease management programs (45%).

Metrics receiving less support include:

• The frequency with which the doctor’s patients use the emergency room for medical problems that could have been treated in the office (30%)
• Whether the doctor uses reminder systems to prompt patients to refill their prescriptions when needed (28%)
• Whether the doctor uses electronic patient medical records (18%)
• Whether the doctor uses electronic systems to prescribe drugs to patients (15%).

"To what extent do you favor or oppose having health insurance plans pay more to doctors if they have been shown to provide higher quality care to their patients?"

Base: All Adults

Note: Percentages may not add up to 100% due to rounding.

"Here is a list of the types of information that health insurance plans might use to judge the quality of care doctors provide to their patients. Which ones, if any, would you want to see used to judge the quality of care that doctors provide to patients? Please select all that apply."

Base: All Adults

"How interested would you be in a health insurance plan that provides access to fewer doctors, but certifies that those doctors provide higher quality care to their patients and charges you lower premium, deductible and co-payment charges?"

Base: All Adults

Note: Percentages may not add up to 100% due to rounding.

Downloadable PDFs of Wall Street Journal Online/Harris Interactive Health-Care Polls are posted at http://www.harrisinteractive.com/news/newsletters_wsj.asp.

This poll was conducted online in the United States between May 11 and 13, 2005 among a nationwide cross section of 2,129 adults aged 18 and over. Figures for age, sex, race/ethnicity, education, income and region were weighted where necessary to align with population proportions. Propensity score weighting was also used to adjust for respondents’ propensity to be online.

In theory, with probability samples of this size, one could say with 95 percent certainty that the overall results have a sampling error of plus or minus 3 percentage points of what they would be if the entire U.S. adult population had been polled with complete accuracy. Sampling error for the various sub-samples of adults with a high school education or less (452), those with some college education (909), college graduates (390), and those with a postgraduate education (378), is higher and varies. Unfortunately, there are several other possible sources of error in polls or surveys that are probably more serious than theoretical calculations of sampling error. This includes refusals to be interviewed (nonresponse), question wording and question order, and weighting. It is impossible to quantify the errors that may result from these factors. This online sample was not a probability sample.

The Wall Street Journal Online/Harris Interactive Health-Care Poll is an exclusive poll that is published in the award-winning Health Industry Edition of The Wall Street Journal Online at www.wsj.com/health.

The Wall Street Journal Online at WSJ.com, published by Dow Jones & Company (NYSE: DJ; www.dowjones.com), offers authoritative analysis, breaking news and commentary from top industry journalists. Launched in 1996, the Online Journal is the largest paid subscription news site on the Web, with more than 689,000 subscribers world-wide. The Online Journal provides in-depth business news and financial information 24 hours a day, seven days a week, with insight and analysis, including breaking business and technology news and analysis from around the world. It draws on the Dow Jones network of more than 1,500 reporters and editors -- the largest staff of business and financial journalists in the world. For the second consecutive year in 2003, the Online Journal received a WebAward for the "Best Newspaper Web Site" and was also cited by Yahoo! Internet Life magazine as the "Best Business News" site (2002 & 2001).

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Harris Interactive Inc. (www.harrisinteractive.com), the 15^th largest and fastest-growing market research firm in the world, is a Rochester, NY-based global research company that blends premier strategic consulting with innovative and efficient methods of investigation, analysis and application. Known for The Harris Poll^® and for pioneering Internet-based research methods, Harris Interactive conducts proprietary and public research to help its clients achieve clear, material and enduring results.

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Nicole C. Pyhel
The Wall Street Journal Online
609-520-4057

Nancy Wong
Harris Interactive
585-214-7316

Kelly Gullo
Harris Interactive
585-214-7172