Limitations of and barriers to using performance measurement: purchaser's perspective, Health Care Financing Review

Although health plan performance data are becoming increasingly more available, many purchasers are still not using these data to make their purchasing decisions. In this article, we review barriers that pri vate purchasers face to using performance data. In addition, we consider the ef fects of the larger health care purchasing environ ment and employers ’ quality improvement activities on their use of the data. We con clude that a variety of factors, including trends, the health care purchasing environ ment, characteristics of firms, and prob lems with performance data and their pre sentation to users create barriers to incor porating this information into health care decisionmaking. BACKGROUND Despite the increasing availability of plan performance data, health care pur chasers still face barriers and limitations to their use. Several different measurement tools exist that provide a variety of data on clinical and service quality indicators of health care. However, these tools and data, while important to some purchasers, are either not used or underused by many of them. This article reviews published litera ture on the limitations and barriers that health care purchasers, both employers Caren Ginsberg and Samantha Sheridan are with Westat. Research for this article was supported by the Health Car