The public release of health care-quality data into more formalized consume
r health report cards is intended to educate consumers, improve quality of
care, and increase competition in the marketplace The purpose of this revie
w is to evaluate the evidence on the impact of consumer report cards on the
behavior of consumers, providers, and purchasers. Studies were selected by
conducting database searches in Medline and Healthstar to identify papers
published since 1995 in peer-review journals pertaining to consumer report
cards on health care. The evidence indicates that consumer report cards do
not make a difference in decision making, improvement of quality, or compet
ition. The research to date suggests that perhaps we need to rethink the en
tire endeavor of consumer report cards. Consumers desire information that i
s provider specific and may be more likely to use information on rates of e
rrors and adverse outcomes. Purchasers may be in a better position to under
stand and use information about health plan quality to select high-quality
plans to offer consumers and to design premium contributions to steer consu
mers, through price, to the highest-quality plans.