Healthcare Slowing Getting More Transparent, But Does it Help Consumers?

Although this year has been marked by several “calls heard round the world” — or at least the country — for improved transparency in healthcare, it’s worth noting that transparency has improved in the industry over the last 10 years.
While pricing transparency is still in its infancy, quality transparency has improved markedly. But does simply making information available mean we’ve achieved true transparency? I’ll explore this question later, but first: a bit about recent quality transparency improvements.
It was just 10 years ago that Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which created the Hospital Inpatient Quality Reporting program. The IQR program reduces Medicare payments to hospitals that fail to report designated quality measures. It wasn’t until this year that hospitals’ Medicare payments were adjusted for actual performance on quality measures (through the Value Based Purchasing Program, created by the Affordable Care Act).
Two years after hospitals began reporting on quality, CMS launched its hospitalcompare.hhs.gov to make hospitals’ quality measures publicly available. However, the site isn’t the most user friendly, and many have argued quality information isn’t utilized by consumers because it’s difficult to locate and make sense of.
A recent op-ed in the New England Journal of Medicine takes a different aim at hospital quality reporting troubles, arguing “the public spotlight is not aimed at information that most patients value.

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By: Staff

The authors, Mark A. Kelley, MD, CMO of Henry Ford Health System, and Robert Huckman, a professor at Harvard Business School, say that instead of providing information to help patients choose a provider once a certain treatment has been selected, “perhaps patients are seeking an answer to a more fundamental and personal question: ‘Is the proposed treatment or procedure the best option given my condition, my financial status, and my social or family situation?'”

The authors promote shared decision-making, where physicians present clear information on risks and outcomes as a better alternative than leaving it to patients to interpret statistical information after a treatment decision has largely been made. However, they warn shared-decision making faces several roadblocks:

“Most clinicians have neither the time nor the financial incentives to make such investments, especially in a fee-for-service environment. With physicians motivated to provide more care and patients lacking the information to question such care, there are few natural brakes on medical utilization. By focusing patients on choosing between providers of specific services, current public reporting thus does little to keep the proverbial horse of medical utilization inside the barn. Indeed, it provides a guided path for its escape.”

For educated consumers who are confident in their course of treatment, current quality data can empower them to choose the best provider for their needs, and that’s a great thing. But I do agree with the authors that quality transparency, just like pricing transparency, has a long way to go.

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