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The impact of information disclosure on quality of care in HMO markets.

The impact of information disclosure on quality of care in HMO markets.
Jung K
Int J Qual Health Care
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OBJECTIVE: To examine the impact of voluntary information disclosure on quality of care in Health Maintenance Organization (HMO) markets in the USA.

SETTING: Commercial HMOs that collected a set of standardized quality meausures, Health Plan Employer Data and Information Set (HEDIS), between 1997 and 2000 in the USA (1062 HMO-years). After collecting the HEDIS data, some HMOs disclosed their HEDIS-quality scores to the public (disclosing HMOs), whereas some HMOs declined to disclose the information (non-disclosing HMOs).

DESIGN: A secondary data analysis based on 4 years of quality scores of HMOs. The study uses non-disclosing plans as a control group. A treatment-effects model is used to address a potential bias associated with voluntary disclosure decisions by HMOs. MAIN OUTCOME MEASURE(s): The study focuses on 13 HEDIS clinical indicators. On the basis of these indicators, a plan-level composite score and four domain scores were constructed. The four domains are childhood immunizations, treatments/exams for chronic conditions, screening tests and maternity services.

RESULTS: Public disclosure leads to an increase of 0.72 composite score units, which corresponds to ∼7% points in original quality scale (0-100%). The degree of quality improvement differed by the type of services.

CONCLUSIONS: Public release of quality information had a significant and positive effect on quality in HMO markets during the earlier years of the voluntary disclosure program; however, the improvement was not universal across all quality measures.


The impact of information disclosure on quality of care in HMO markets. Jung K. Int J Qual Health Care 2010; 22(6):461-8.

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