How did you choose your doctor? If you're like most Americans, you probably didn't have access to enough information and was thus unable to make an informed choice about who to consult about your health.

The Health Care Incentives Improvement Institute released a new report where the District of Columbia and 40 states received a failing mark of "F" because they didn't meet standards. Four other states were given a "D," which is no better because that is also a failing mark. What are these scores for, anyway? These are ratings for states based on how well they provide the public with information about doctors. And given their scores, not very well.

The report "State Report Card on Transparency of Physician Quality Information" yielded results not very different from the one released in 2013. Aside from the same offenders, 2013's model states, Washington and Minnesota, were also the same ones receiving an "A" this year.

Ratings are based on how accessible information is regarding doctors as well as the level of quality the information has. Given that employers, policymakers and insurance companies are pushing for health care transparency, the results of the report are disappointing. Millions of Americans are receiving medical care through the Affordable Care Act, but they could be enjoying improved care had they been given access to information they can use in choosing their doctors.

"Consumers are flying blind when it comes to selecting hospitals and physicians, and the overall quality and affordability of American health care won't be improved until we find a way to solve this problem," said HCI3.

Additionally, the report's goal is not just to simply recognize the efforts of states that are doing great but to also attract the attention of lawmakers in those states that are not providing their residents with the information they need.

Only six states received passing grades with a "C" rating or higher. Aside from Washington and Minnesota, these include Maine and California, which received a "B" and Massachusetts and Wisconsin with a "C."

To earn an "A," a state must allow for the comparison of doctor practices using several measures of performance as well as the overall experience of a patient after a visit to a particular doctor. Minnesota, for instance, lets consumers compare practices based on certain conditions such as colon cancer or asthma care through a website.