Health maintenance organization report cards: communication strategies versus consumer abilities

Consumers have a hard time understanding health maintenance organization (HMO) report cards. Current HMO report cards do not consider three psychological factors that affect consumers' ability to use the report card: working memory (the ability to simultaneously retain and manipulate information), cognitive complexity of the card (the number of criteria that must be integrated to make a decision), and consumers' thinking abilities (ranging from concrete to abstract). Because working memory and thinking skills decline with age, older consumers may find it particularly difficult to interpret government-sponsored report cards.