In contrast to the still rather limited use of public report cards by state and national governmental organizations, healthcare professional societies, and regional consortia, there has been an unrestrained and rapid proliferation of direct-to-consumer, online healthcare rating sites with substantial potential to impact consumer behavior. Some of these sites use publicly available data from Medicare, including outcomes. However, patient experience is a dominant focus of many sites, in some instances derived from psychometrically validated survey data but more often relying on unvalidated surveys and patient narratives. Some studies have shown correlations between online ratings of hospitals and more objective, data-driven assessments, but online physician ratings have not shown consistently strong correlations and are often based on a limited number of observations. Overall, though online ratings may complement traditional report cards, they are often less methodologically credible and may distract consumers from more credible, objective data sources.