The California HealthCare Foundation lauds the announcement today by Blue Shield of California that it will add quality and patient experience measures to the hospital cost data provided under its network choice program. The new measures will include the Patients' Evaluation of Performance in California (PEP-C) survey, a groundbreaking project that established for the first time a meaningful, scientifically valid survey of patient experience in California. PEP-C is a collaborative effort of the California Institute for Health Systems Performance and the California Health Care Foundation.

"We are gratified that Blue Shield has integrated PEP-C and Leapfrog scores with its network choice program," said Ann Monroe, director of the California HealthCare Foundation's Quality Initiative. "It's critical for consumers to be able to evaluate quality and performance data in the same context as cost information, especially when they are considering expending out-of-pocket dollars for care."

Monroe said that by making it possible for hospitals to alter their tier status by participating in PEP-C, Blue Shield is also sending an important signal to hospitals that quality does matter and that health care is not simply a commodity to be purchased at the lowest possible cost. "As with other goods and services available to the consumer, cost and quality should be inseparable," she said.

PEP-C is currently recruiting hospitals for its second round. When first reported in August 2001, it was the largest publicly reported patient experience survey every conducted and included responses from 21,151 individuals who spent at least one night in one of the 113 participating California hospitals (just a third of those eligible to participate). The number of participating hospitals has increased for the second round with just a few weeks remaining for hospitals to commit to the program. PEP-C measures the patient's experience of hospital performance on such important indicators as appropriate pain management, preparedness for discharge, and clear, respectful communication. Research has shown patient experience surveys of this kind to correlate strongly with clinical outcomes.

Marsha Nelson, vice president of CIHSP, noted that the timing of the announcement could influence additional hospitals to participate in the second round of the survey, which will go into the field this fall and be published in the summer of 2003. "There are just a few weeks left for hospitals to sign up. The value of this project to California consumers is directly related to the number of hospitals volunteering to participate. We believe that PEP-C participants — even hospitals with lower than average scores — are more likely to be actively focused on improving the patient experience in their facilities than non-participants."

According to yesterday's announcement by Blue Shield, the new quality and patient experience criteria will go into effect October 1, 2002. Hospitals currently in the Affiliate category (facilities whose costs are substantially greater than average and for which patients pay an additional copayment or coinsurance fee) can move into the Choice category (hospitals in which care is fully covered by Blue Shield), based on their participation in both the PEP-C and Leapfrog quality evaluation programs, provided their costs are not significantly above the regional norm. Hospitals currently in the Choice category also may shift to Affiliate reflecting new cost data. Affected members will be notified of changes in the fall.