Testing consumers' comprehension of quality measures using alternative reporting formats.

CMS has publicly reported nursing home quality measures since 2002, but research has shown that many users do not understand them. Alternative visual displays may improve comprehension. We developed seven reporting templates in different formats, including bar graphs like those displayed on the CMS Nursing Home Compare Web site www.medicare.gov, and tested them with 90 individuals age 45-75, using structured protocols. Tests of significance were conducted, and statistically significant findings identified. Fewer than one-half the respondents accurately interpreted bar graphs as currently displayed on the Nursing Home Compare Web site. Respondents made fewest errors on templates using words to characterize performance as better, average, or worse.