Newtown, CT – December 20, 2013
With only a few days left before Christmas, the shopping frenzy is in full swing. Consumers are pouring through web sites, stores and catalogues, comparing prices, quality, and making decisions – Comparison-shopping isn't a new behavior. In fact it's been around for as long as there's been more than one merchant, store or other provider of goods and services. Thousands of years ago prudent shoppers would stop by the stalls in a market, examine the vegetables and fruits, compare prices and make a purchase. And I think that's why it's so frustrating that we just can't do the same thing for one of the more important purchases in our lives: health care. Certainly, hospitals and physicians will be deeply offended that we dare compare the process of shopping for fruits and vegetables or even Christmas gifts with shopping for health care services, but they shouldn't because it's not the product or service we're referring to, but rather the ability for consumers to make decisions they feel comfortable with. In a recent blog post, our colleague talks about her personal experience flying blind in an opaque system. And that is the point. It's not that consumers don't want to make these informed decisions; it's simply that they're not even offered the opportunity to make them.
What this means to you – Our recent report on the Transparency of Physician Quality joins a prior report on the Transparency of Health Care Prices and both expose the abysmal lack of information on which consumers can make informed decision in health care. How is this justifiable by policymakers at the State or Federal level? It truly is baffling and unless citizens in each State decide to change the status quo, it likely won't. Too many are comfortable under this cloak of darkness to give it up voluntarily. Fortunately, there are some encouraging signs and good examples to follow. First, CMS recently released some actual ratings of hospitals on outcomes of joint replacements. Whlie the vast vast majority of facilities were "indistinguishable" from the average, some had significantly better or worse outcomes and all consumers should pay attention. This continues a very positive release of information from CMS that should accelerate in 2014. Second, some states like Maine, Massachusetts, Minnesota, California, and Washington have been collecting, reporting and rating physician performance for some time and performance has improved. While their focus has been on PCPs, the stage is set for further deployment of quality ratings. So it's not that this information can't be collected, reported and made useful to consumers, it's that those that benefit from opacity don't want to see it end. And they're right to be afraid because thousands of years of experience tell us that consumers will use the information, compare the quality and prices of health care services, and make their own value decisions. We'll certainly continue to do our part to make sure that day comes soon.