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Do Report Cards Tell Consumers Anything They Don't Already Know? The Case of Medicare HMOs

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  • Leemore Dafny
  • David Dranove

Abstract

The use of government-mandated report cards to diminish uncertainty about the quality of products and services is widespread. However, report cards will have little effect if they simply confirm consumers' prior beliefs. Moreover, documented "responses" to report cards may reflect learning about quality that would have occurred in their absence ("market-based learning"). Using panel data on Medicare HMO market shares between 1994 and 2002, we examine the relationship between enrollment and quality before and after report cards were mailed to 40 million Medicare beneficiaries in 1999 and 2000. We find evidence that consumers learn from both public report cards and market-based sources, with the latter having a larger impact during our study period. Consumers are especially sensitive to both sources of information when the variance in HMO quality is greater. The effect of report cards is driven by beneficiaries' responses to consumer satisfaction scores; other reported quality measures such as the mammography rate did not affect enrollment decisions.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 11420.

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Date of creation: Jun 2005
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Handle: RePEc:nbr:nberwo:11420

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Cited by:
  1. Dwyer, Debra Sabatini & Liu, Hong, 2013. "The impact of consumer health information on the demand for health services," The Quarterly Review of Economics and Finance, Elsevier, vol. 53(1), pages 1-11.
  2. Abe Dunn, 2009. "Does Competition Among Medicare Advantage Plans Matter?: An Empirical Analysis of the Effects of Local Competition in a Regulated Environment," EAG Discussions Papers 200905, Department of Justice, Antitrust Division.
  3. Abe Dunn, 2010. "The Value of Coverage in the Medicare Advantage Insurance Market," BEA Working Papers 0061, Bureau of Economic Analysis.
  4. David Dranove & Ginger Zhe Jin, 2010. "Quality Disclosure and Certification: Theory and Practice," NBER Working Papers 15644, National Bureau of Economic Research, Inc.
  5. M. Kate Bundorf & Natalie Chun & Gopi Shah Goda & Daniel P. Kessler, 2008. "Do Markets Respond to Quality Information? The Case of Fertility Clinics," NBER Working Papers 13888, National Bureau of Economic Research, Inc.
  6. Wübker, Ansgar & Sauerland, Dirk & Wübker, Achim, 2008. "Does better information about hospital quality affect patients’ choice? Empirical findings from Germany," MPRA Paper 10479, University Library of Munich, Germany, revised 09 Sep 2008.
  7. Dana Goldman & John A. Romley, 2008. "Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand," NBER Working Papers 14619, National Bureau of Economic Research, Inc.
  8. Friesen, Jane & Javdani, Mohsen & Woodcock, Simon D., 2009. "Does Public Information about School Quality Lead to Flight from Low-Achieving Schools?," IZA Discussion Papers 4632, Institute for the Study of Labor (IZA).
  9. Shiko Maruyama, 2006. "Welfare Analysis Incorporating a Structural Entry-Exit Model: A Case Study of Medicare HMOs," Hi-Stat Discussion Paper Series d06-166, Institute of Economic Research, Hitotsubashi University.
  10. Figlio, David N. & Kenny, Lawrence W., 2009. "Public sector performance measurement and stakeholder support," Journal of Public Economics, Elsevier, vol. 93(9-10), pages 1069-1077, October.
  11. Shiko Maruyama, 2008. "Measuring the Welfare Effect of Entry in Differentiated Product Markets: The Case of Medicare HMOs," Discussion Papers 2008-01, School of Economics, The University of New South Wales.
  12. Werner, Rachel M. & Norton, Edward C. & Konetzka, R. Tamara & Polsky, Daniel, 2012. "Do consumers respond to publicly reported quality information? Evidence from nursing homes," Journal of Health Economics, Elsevier, vol. 31(1), pages 50-61.
  13. Lieke H. H. M. Boonen & Frederik T. Schut & Xander Koolman, 2008. "Consumer channeling by health insurers: natural experiments with preferred providers in the Dutch pharmacy market," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 299-316.

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