insurance

Rating health care online

For nearly all procedures, about 12 percent of hospitals earn five stars, another 12 percent get one star and the rest come in with three stars, creating a pretty distinct bell curve, Loughran says. The differences between the ratings can be meaningful. A 2008 study by Healthgrades found that patients' chances of dying are 70 percent lower at top-rated hospitals than at lower-rated ones.

4. Consumer reviews

Several Web sites have added consumers' reviews of health care providers. AngiesList.com, which got its start providing reviews of home repair companies, now offers members' reviews of doctors, including such information as cost, the length of time spent waiting in the exam room and the staff's helpfulness. Similarly, Yelp.com, which originally offered reviews of restaurants and clubs, now provides members' assessments of their doctors in some cities.

Not the whole story

Most experts agree that while you can use these reviews to complement what you learn elsewhere, it would be foolhardy to rely on them. You need to look at medical outcomes, says Valerie Wedin, national health care communications champion with Watson Wyatt.

Clearly, you should expect that doctors' appointments will proceed reasonably promptly and that the staff will treat you respectfully. However, it could be dangerous to avoid a qualified professional because one reviewer had an unpleasant experience.

While all these Web sites can help when you're choosing health care providers, they're not perfect. For starters, to accurately determine your cost, the sites would need to factor in your health care plan, as each plan negotiates different rates with providers. Instead, most sites give a range of prices across networks.

What's more, measuring the quality of health care isn't straightforward. Doctors worry that their ratings may suffer if, for instance, they take on patients whose conditions are more complicated. And, if a measure includes only small groups of patients, the results can be skewed by a few extreme cases. 

Even so, measuring and reporting quality can make a difference. One report, "The State of Health Care Quality 2008," by the National Committee for Quality Assurance in Washington, D.C., found that for the ninth consecutive year, health plans that reported quality measurements provide better care. To take one example, the report estimates that between 76,000 and 132,000 lives were saved between 1996 and 2007 as a result of blood pressure control measures put in place by what it calls "accountable plans," or those that report quality measurements.

That's why, despite the imperfections in the current methods for measuring health care cost and quality, it's critical that they continue to improve. Many of the variations between patient populations can be adjusted for, making the ratings more meaningful. Moreover, the notion that patients should remain in the dark no longer is acceptable, says Josh Seidman, president of the Center for Information Therapy in Bethesda, Md. "It's important to continue to push the envelope and make the systems better and do that in a public, transparent way."

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