The Affordable Care Act (ACA) is the law of the land but it has promised a lot - higher quality, lower prices and government-run. Will it be able to do all that?
Health care reform advocates are now tasked with going from being part of the outside advocacy groups and more towards part of a solution, but Bob Kocher, MD, and Ezekiel Emanuel, MD, PhD, are still advocating. Now they want a "transparency imperative" to achieve higher quality and cost control under the new health care system.
According to Drs. Kocher and Emanuel, the lack of price and quality transparency in U.S. health care promotes high costs, but not necessarily high quality care - the foreign travelers who leave their nationalized medicine countries and go to hospitals in the US say otherwise. The Drs. propose that all data on price, utilization, and quality be made publicly available unless there is a compelling reason to keep it confidential.
People are already concerned about access to their personal health data and that would have to be turned over to the government next. The Obama administration will need to relax privacy restrictions on public access to Medicare data. The authors write that all payers should make claims data publicly available, with a new set of privacy protections to enable quality measurement. Patients should know how many procedures a physician has performed (utilization), and have access to outcomes data for hospitals (quality).
Personalized pricing information also should be made available so that patients can make comparisons. Currently, it is almost impossible for patients to obtain pricing information for health care services. Within local markets, different hospitals may have price disparities of more than 200%, with little or no correlation between cost and quality.
The authors conclude that "transparency is essential for patients to consume care from providers who deliver greater value." They assert that the transparency approach will promote competition and is the best way to overcome local monopoly pricing power by providers.
Published in Annals of Internal Medicine.