Using "Roll-up" Measures in Healthcare Quality Reports

Perspectives of Report Sponsors and National Alliances

Published in: The American Journal of Managed Care, Volume 23, No. 6, pages e202-e207

Posted on RAND.org on July 14, 2017

by Jennifer Cerully, Steven Martino, Melissa L. Finucane, Rachel Grob, Andrew Parker, Mark Schlesinger, Dale Shaller, Grant Martsolf

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Research Questions

  1. What are some current report sponsor practices in reporting "roll-up" measures of health care quality, which combine indicators of multiple, often disparate, dimensions of care?
  2. Among report sponsors and national alliances representing stakeholder groups affected by quality reporting, what are the perceived benefits and drawbacks for reporting roll-up measures of health care quality?

Objectives

To understand the views of prominent organizations in the field of healthcare quality on the topic of reporting roll-up measures that combine indicators of multiple, often disparate, dimensions of care to consumers.

Study Design

This study used a semi-structured, qualitative interview design.

Methods

We conducted 30- to 60-minute semi-structured telephone interviews with representatives of 10 organizations that sponsor public healthcare quality reports and 3 national alliances representing multiple stakeholder groups. We conducted a thematic analysis of interview transcriptions to identify common issues and concerns related to reporting roll-up measures.

Results

Among sponsors reporting roll-up measures, current practices for calculating and reporting these measures are diverse. The main perceived benefit of reporting roll-up measures is that they simplify large amounts of complex information for consumers. The main concern is the potential for consumers to misunderstand the measures and what associated roll-up scores communicate about provider performance. Report sponsors and national alliances feel that more guidance and research on the methods for producing and reporting scores for roll-up measures are needed.

Conclusions

The results of the interviews elucidate the need for research focused on construction and reporting of roll-up measures. Studies are needed to determine if roll-up measures are indeed perceived by consumers as being less complex and easier to understand.

Key Findings

  • Report sponsors' practices for calculating and reporting these measures are diverse.
  • Report sponsors and national alliances representing stakeholder groups affected by quality reporting feel that roll-up measures simplify large amounts of complex information for consumers, but consumers may misunderstand the aspects of quality captured by roll-up measures and what they communicate.
  • Report sponsors and national alliances report needing more guidance and research on how to produce and report scores for roll-up measures.

Recommendations

  • The findings in this manuscript point to the need for a research agenda focused on developing standards for the construction, calculation, and reporting of roll-up measures that are rooted in empirical data on how constructs assessed by various performance measures relate to each other and desired health outcomes.
  • The findings also highlight the need for building the body of published research on consumer use of and responses to roll-up measures.

Research conducted by

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