Rich Daly | March 17, 2015
Patients appear increasingly interested in price and quality information, although they may not use such information in ways providers have assumed.
March 17—Few providers are able to access price and quality data compiled by payers, despite increasing efforts to make such information available to patients, according to healthcare transparency experts.
Most of the major national insurers recently surveyed by the Catalyst for Payment Reform (CPR), which seeks healthcare cost and quality improvements on behalf of employers, said they are not extensively allowing providers to access much of the cost and quality data they offer enrollees on other providers. The organization asked about insurers’ policies on sharing data with providers after its employer members expressed frustration with “the roadblocks to providers’ having the information they need to make good referrals,” said Suzanne Delbanco, executive director of CPR.
The reluctance is “because it is proprietary information, it’s for the patient only—and this is just sort of an absurd situation,” Delbanco said during the Second National Summit on Health Care Price, Cost and Quality Transparency, sponsored by the Robert Wood Johnson Foundation, March 16-18 in Washington, D.C.
A few insurers said they provide a version of their transparency tools to providers in some cases—for instance, when providers need information to make referral decisions.
“We know that the information is critical for them to be able to succeed under new forms of payment,” Delbanco said.
However, even when such information is offered to providers, Delbanco cautioned that it needs to be part of the physicians’ workflow and not located on “some other website,” which physicians are unlikely to access during busy workdays.
Robert Dubois, MD, chief science officer at the National Pharmaceutical Council, agreed that physicians need to know the prices of various medical treatment options when prescribing them to help ensure patients can afford treatment.
Importance of Transparency
The interest in greater price and quality transparency among the public appears to be increasing. A nationally representative survey of 2,010 adults released March 17 by Public Agenda reported that 56 percent of Americans have actively looked for such information before obtaining care. Twenty-one percent have compared prices across multiple providers, and those who have compared prices say doing so has affected their choices and saved them money.
The findings came amid a growing number of price transparency initiatives, and lingering concerns that comparative quality data is much more difficult to provide.
“Quality is not an easy turnkey solution; it is somewhat nuanced and complicated,” said Jennifer Schneider, MD, CMO at Castlight, a healthcare cost management consultancy.
The complexity of quality information has caused concern among providers that a dearth of such information would lead consumers to use increasingly available price data as a surrogate when selecting providers. But the new public survey cast doubt on that assumption.
Specifically, 71 percent of respondents said higher prices are not typically a sign of better-quality medical care, and 43 percent of those who have never tried to find provider prices said they would use such data to choose less expensive physicians.
Among the quality information that patients say they prefer to have to make decisions about providers, Schneider said, was provider-specific data and information on patient-reported outcomes.
Such patient-reported outcomes may become a way to overcome longstanding and serious divisions within the healthcare industry over which quality information is most appropriate to share, said William Kramer, executive director for national health policy at the Pacific Business Group on Health, an employer group.
Source: HFMA