In a Changes in Health Care Financing and Organization (HCFO) study, Jinnet Fowles, Ph.D., vice president of the Park Nicollet Institute for Research and Education at HealthSystem Minnesota, David Knutson, also of Health-System Minnesota, and Jon Christianson, Ph.D., professor at the University of Minnesota, examined a Minnesota-mandated report card initiative that began in 1991 and required all health plans selling policies to state employees to participate in a consumer survey-based report card. They found that within four years, some of the five1 plans involved had undergone a significant degree of internal restructuring to improve their quality ratings, including restructuring key front-line positions, garnering additional support for quality improvement initiatives, and reorienting clinics toward service quality initiatives. Through a series of interviews and case studies, the researchers found that the implementation of the report card initiative was generally cited as an incentive for the increased attention given to quality improvement and service initiatives.
