Associate Provost for Research Boston University Medical Campus
NIMH - National Institute of Mental Health	Research Resources

Abstract

Abstract: DESCRIPTION (provided by applicant): There is a general consensus that consumers have too little accurate information about quality, and by improving what consumers know, health care markets will function better. We emphasize, however, that revealing "more information" is a double-edged sword for mental and other chronic illnesses in policy contexts, such as consumers' choice of health plans, in which forces of adverse selection are also affecting quality. From the standpoint of incentives to providers and plans, revealing more information about the quality of care for a condition like mental illness can exacerbate incentives to reduce quality. In this R34 application, we cast the decision of what to report to consumers about quality as a policy instrument. Our central goal is to find ways to balance the gains from better-informed consumers against the costs of creating unintended incentives to reduce quality of care for mental illnesses. The specific aims are: Aim 1: Conduct a formal economic analysis of the role of information about quality on incentives to supply quality in mental health care. Establish that the current trend in health services of providing consumers with more detailed and service-specific information may reduce quality in mental health care. Demonstrate that grouping mental health with other services in a quality report is a superior policy. Aim 2: Generalize the analysis. Make concrete recommendations about the form of quality reports by deriving a formula for grouping mental health with other services in a quality report, relying on data on patterns of cost and need. Aim 3: Conduct preliminary tests of the recommendations from Aims 1 and 2. Assess the "state of the art" in quality reporting in mental health. Modify the CAHPS quality report based on our findings. Conduct a preliminary assessment of consumer understanding/reaction with focus groups. Assess initial reaction of the modified report from health plans.

Thesaurus Terms:
health care quality, health care service utilization, health economics, health insurance, mental health service
cost effectiveness, information dissemination, managed care
clinical research, focus group, health services research tag, human subject

Institution:	BOSTON UNIVERSITY
	881 COMMONWEALTH AVENUE
	BOSTON, MA 02215
Fiscal Year:	2006
Department:	ECONOMICS
Project Start:	12-JUL-2004
Project End:	30-APR-2007
ICD:	NATIONAL INSTITUTE OF MENTAL HEALTH
IRG:	SRV