Demand Transparency To Drive Value-Driven Healthcare

I wanted to finish our conversation from yesterday. We talked about how perverse the health insurance system is; that, contrary to all other types of insurance, we fully expect all of our healthcare costs to be covered by insurance. Even with modest deductibles, people are sacrificing their health by postponing doctors visits and critical prescription medications. There are other ways to fight the high costs of healthcare even in this climate of rising health insurance costs. It is called value-added healthcare. If we were able to find out how our healthcare system is performing and what the costs are, we can choose for ourselves the  best available care. In doing so, we’ll drive those who are providing expensive poorer care out of business or, at least, to try to improve their services. The problem arises with transparency.

Transparency and better public information on cost and quality are essential for three reasons: 1) it helps providers improve by benchmarking their performance against others; 2) it encourages private insurers and public programs to reward quality and efficiency; and 3) it helps patients make informed choices about their care. Transparency is also important to level the playing field. The widespread practice of charging patients different prices for the same care is inherently inequitable, especially when the uninsured are charged more than other patients.

The problem is many states do not require healthcare providers to provide such information. Wisconsin is the exception. Since 2003 the state legislature has provided its citizens with an easy to navigate website to get the information they need to choose a provider who scores high in quality of care.

For instance, treating a pneumonia case at the Theda Clark Medical Center  in Neenah averaged $10,435 in 2008. Sacred Heart Hospital in Eau Claire, on the other hand, charged the average pneumonia patient $20,419, nearly twice as much.

What shocked hospital administrators most were the results for quality. Instead of higher cost hospitals delivering better care, the evidence pointed to just the opposite: The higher cost hospitals were less likely to meet benchmarks for quality. Theda Clark attained 95.5 percent of the quality goals outlined for treating a pneumonia case in 2008. Sacred Heart met just 90.5 percent of the standards.

Never mind that we as patients need this information, but how do hospitals and doctors know whether the care they’re providing is good if it is not measured?? They treat for pneumonia a certain way, discharge and never find out how the patient did? Up until recently, GM did that with its automobiles and look where it got them?

Does your state doesn’t provide such information? If not ask your representative, how come?

The Affordable Care Act preaches transparency but does not contain any legislation on providing it. Representative Steve Kegan (D-WI) introduced a bill, The Transparency in All Health Care Pricing Act which require public reporting of price information for almost every entity that participates in providing healthcare. However, this bill appears to be going no where.

If we want to hold down the costs of healthcare while maintaining high quality care (value-driven healthcare) we must demand that prices and healthcare outcomes be made public. We demand this for almost everything else that goes on in our lives. Where is the outrage!


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