The potential of price transparency tools to help consumers with high out-of-pocket medical expenses remains largely untapped, according to two recent studies published in Health Affairs and other recent research by Consumer Reports and Public Agenda.
One study found that while more than half of the nearly 3,000 patients surveyed said they would use a website to shop for healthcare if they knew of one, only 13 percent actually looked for information on future healthcare spending and only 3 percent compared prices and costs across providers.
In the second study, patients with access to a price transparency tool focused on “shoppable” services did not experience overall lower spending on those services, and only 12 percent used the tool to begin with. On a positive note, patients who compared prices for imaging tests decreased spending an average 14 percent.
Research by us at Consumer Reports and a survey by Public Agenda (publicagenda.org) signals additional cautious hope for consumer’s use of price transparency tools in the future. Both projects were sponsored by the New York State Health Foundation (nyshealthfoundation.org) and received additional funding from the Robert Wood Johnson Foundation (rwjf.org).
Health Datapalooza once again lived up to its reputation as the liveliest and most eclectic health IT confabs of the year. Energetic and sleek young entrepreneurs mingled with government bureaucrats, academic types, consultants, current and former ONCers, a smattering of providers, app developers, data geeks, and patient advocates at this year’s conference, held in Washington D.C. June 1 to 3 with about 2,000 in attendance.
Although the speeches, app demonstrations, and panel sessions broke little new ground, that’s not the point. The point is to maintain the excitement, optimism and commitment, to update the vision, showcase the creativity, and extol the virtues and power of data-driven care improvement. Perhaps not as the solution to all the health system’s woes, but a fair share of them.
I didn’t discern a dominant theme, but amid the ra-ra and fun there was a good amount of hand-wringing around these issues:
1. Failure to engage the vast majority of consumers/patients in their own care—with data, medical records and Yelp reviews in hand. Some two-thirds of providers attesting to stage 2 meaningful use reported that not a single patient had requested their data or records. Continue reading…
At Health 2.0 WinterTech: The New Consumer Health Landscape speakers and sponsors are exploring the platforms that empower the informed consumer movement by providing objective reviews of consumer products. Senior Director, of Health Impact and Consumer Reports, Tara Montgomery will be joining the event to speak to their research on the health products, prescriptions, and providers that contribute to the changing consumer health landscape.
Health 2.0: Tara can you start by speaking to what really pushed this expansion into research and advocacies surrounding health products and when you sort of saw this started shifting?
Tara Montgomery: Yes. Well, actually, you might not know, but we have been in health since day one, and it was actually in our charter back in 1936 to look out for the well-being of all consumers. We started in our very first issue of our magazine and we rated Alka-Seltzer and said that its claims vanish — like gas bubbles in the air. So that was our first foray into health, but that was in a small scale, and I think it was typical of the kinds of health products being advertised to consumers earlier in the 20th century, but over the decades, we covered health lightly. And then, really, about 10 years ago, we saw the shift in healthcare where the consumer’s role really was shifting much more consciously from a compliant patient to a need to be a more savvy health consumer. That was a real call to action for us because our role in helping consumers out in the world is really to give people savvy information about value, and everything we’ve done in washing machines and cars and toasters has been about helping people evaluate the benefits, their satisfaction, and the value for money of the products and services they choose. When the burden of health costs started to shift towards consumers, and you know that definitely has been more intense in the past couple of years, we’ve needed to rise to the occasion and helpconsumers navigate that new role. So, that was a moment for us along with transparency, because when we wanted to rate healthcare products and services more than 10 years ago, the data wasn’t available, and obviously, you can’t look at health the same way as we look at cars and washing machines and bang — our national lab.Continue reading…
Last April, the ABIM Foundation, with Consumer Reports and other partners, drew national attention to overuse of ineffective and harmful practices across the health care system with their Choosing Wisely campaign. As part of the campaign, professional medical societies identified practices within their own specialties that patients should avoid or question carefully. Today, the American Congress of Obstetricians and Gynecologists (ACOG) and the American Association of Family Physicians (AAFP) have joined the campaign, drawing national attention to the overuse and misuse of induction of labor. ACOG and AAFP are telling women and their maternity care providers:
1. Don’t schedule elective, non-medically indicated inductions of labor or cesarean deliveries before 39 weeks 0 days gestational age.
2. Don’t schedule elective, non-medically indicated inductions of labor between 39 weeks 0 days and 41 weeks 0 days unless the cervix is deemed favorable.
(“Favorable” means the cervix is already thinned out and beginning to dilate, and the baby is settling into the pelvis. Another word for this is “ripe,” and doctors and midwives use a tool called the Bishop Score to give an objective measurement of ripeness. Although ACOG and AAFP do not define “favorable,” studies show cesarean risk is elevated with a Bishop Score of 8 or lower in a woman having her first birth and 6 or lower in women who have already given birth vaginally.)
Much work has already been done to spread the first message. Although ACOG has long advised against early elective deliveries, the practice has persisted. But a confluence of recent reforms has made it increasingly difficult for providers to perform elective deliveries before 39 weeks. Quality collaboratives have supported hospitals to implement “hard stops” that prevent these deliveries. Payers have used carrots and sticks to disincentivize them. CMS has funded a national public awareness campaign to reduce consumer demand.
By year’s end, the Department of Health and Human Services will announce plans for making its Physician Compare website into a consumer-friendly source of information for Medicare patients about the quality of care provided by doctors and other health care providers. In doing so, Physician Compare will take its place alongside Hospital Compare and more than 250 other websites that offer information about the quality and cost of health care. More importantly, perhaps, it will send an important signal that transparency in health care is the new normal.
To look at these 250-plus online reports is to see the good, the bad, and the ugly of the public reporting aspect of the transparency movement. Some make it easy for people to make choices among physicians and hospitals, and just as notably, let providers see where they fall short and need to improve care. But others ask too much, forcing users to sort through rows and rows of eye-glazing data and jargon that requires a medical degree to fathom.
The Affordable Care Act calls for Physician Compare to offer information about the quality of care, including what physicians and their practices did and the outcome for patients, as well as care coordination; efficiency and resource use; patient experience and engagement; and safety, effectiveness, and timeliness. That’s a lot of information, and it demonstrates the tall order facing the federal government to make the reports meaningful and accessible, so that physicians and patients will both be more apt to use them.Continue reading…
After years of breaking down, my sedan recently died. Finding myself in the market for a new car, I did what most Americans would do – went to the web. Reading reviews and checking rankings, it quickly became clear that each website emphasized something different: Some valued fuel-efficiency and reliability, while others made safety the primary concern. Others clearly put a premium on style and performance. It was enough to make my head spin, until I stopped to consider: What really mattered to me? I decided that safety and reliability were my primary concerns and how fun a car was to drive was an important, if somewhat distant, third consideration.
For years, many of us have complained about the lack of similarly accessible, reliable information about healthcare. These issues are particularly salient when we consider hospital care. Despite a long-standing belief that all hospitals are the same, the truth is startlingly different: where you go has a profound impact on whether you live or die, whether you are harmed or not. There is an urgent need for better information, especially as consumers spend more money out of pocket on healthcare. Until recently, this type of transparent, consumer-focused information simply didn’t exist.
Over the past couple of months, things have begun to change. Three major organizations recently released groundbreaking hospital rankings. The Leapfrog Group, a well-respected organization focused on promoting safer hospital care, assigned hospitals grades (“A” through “F”) based on how well it cared for patients without harming them*.
What happens when consumers are able to compare the performance of primary care physicians in their state using Consumer Reports, the magazine that’s so highly regarded for its ratings of thousands of products and services we all use every day? Well, for the first time ever, we’re about to find out.
A special Massachusetts version of July’s Consumer Reports magazine will feature a report entitled “How Does Your Doctor Compare?” along with a 24-page insert that includes ratings of nearly 500 primary care physician practices from across the state. The ratings are based on data from a comprehensive patient experience survey conducted by Massachusetts Health Quality Partners (MHQP), a coalition of consumers, physicians, hospitals, insurers, employers, government agencies, and researchers. The physician ratings report is also available online at www.mhqp.org.
In recent years, there’s been a lot of talk in the health care community about the importance of consumer empowerment and patient-centered care. This experimental collaboration between MHQP and Consumer Reports, funded by the Robert Wood Johnson Foundation’s Aligning Forces for Quality program, helps move theory into practice, and will test some key assumptions about the value of transparency in the effort to improve the health care system. In many respects, ratings of primary care physicians are not new to Massachusetts. We at MHQP have been reporting the results of patient surveys and clinical quality data since 2006 and these reports have had a positive effect on health care in our state. But let’s face it, Consumer Reports adds a whole new dimension to the notion of transparency. Not surprisingly, their involvement has been met with both excitement and some trepidation in the physician community.Continue reading…