HCI3 Update from the Field: Forces of the Status Quo

Submitted by francois.debrantes@hci3.org on Friday, April 25, 2014 - 01:12

Newtown, CT – April 25, 2014

In our recent Scorecard on Price Transparency, Massachusetts got a B – one of the best grades. So imagine our surprise when the Data Review Committee balked at our efforts to further the State Law's goal – The legislation that enables the all-payer claims database in Massachusetts clearly specifies that the goal is to disclose pricing information on health care services and procedures for facilities, physicians and medical practices. However, to-date, the website in MA only focuses on facilities and medical groups, not practices or physicians. The website itself is not particularly good or useful, which is why MA got a B rather than an A. Organizations like HCI3 can request a copy of the APCD for various reasons and our application included an intended use to measure the rate of potentially avoidable complications (a NQF-endorsed comprehensive outcomes measure) in the management of chronic conditions by physicians. Further, we plan to publish this information on our public transparency website (it's free) and also provide it back to the APCD Council for their own use. In other words, our proposed use is to help MA meet its obligations under its own legislation. The hue and cry from the majority of the Data Review Committee was deafening, even though some on that Committee rightfully pointed out that our proposal was very much in the spirit of the legislation.

What this means to you – Even in the more "transparent" states, the forces of the status quo control many of the committees and agencies that are empowered to transform healthcare. The comments from some DRC members were amusing because it's the same pile of horse manure that has been spread for years: "How can you possibly hold physicians accountable for complications when we all know that it's the patient's non-compliance that causes those complications"….Seriously? That old saw is so used up that no one pays attention to it in the real world. But in the world of committees and bureaucracies it continues to hold sway and no one should underestimate the power of inertia and reactionary thinking. There's simply no excuse for withholding important information on the cost and quality of health care delivered to patients by physicians…not just large amorphous medical groups. Consumers have a right to know and we intend to protect that right. So we'll be back in front of the DRC soon enough, and for as long as it takes to get the data that, by law, they should provide us so that despite their unwillingness to do so, we can help fulfill the spirit and letter of the MA legislation. And we're also knocking on the doors of all other APCDs and the federal government to accomplish the same task, with the same determination. Those who plan to say no better get ready for the fight of their careers in the public square, because that's where we're taking this. We're not staying behind closed doors, we're going to bust them open and let the light shine where it should.