Health IT companies such as Castlight Health and PokitDoc are some of the businesses working to improve price transparency in the healthcare industry. The demand for the service they provide is underscored by the $400 million in investments these and other companies in this vein have attracted since 2010.
A Google Hangout hosted by the Robert Wood Johnson Foundation talked about challenges to making price transparency for medical procedures the rule rather than an exception. It also highlighted companies and initiatives that were changing the status quo.
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One challenge is giving consumers more information not just on prices for procedures but outcomes as well. The idea is to do away with the notion that higher prices equate with better outcomes.
Outlawing gag clauses would be a big step toward transparency, said Susan Dentzer, senior health policy adviser with the Robert Wood Johnson Foundation. This is about the contract between a physician and their managed care provider about what they can divulge about procedures, not so much the gun issue that some states have added.
Regional health improvement collaboratives are expanding in a handful of states to provide a way for stakeholders like hospitals, health plans and consumers to get healthcare information in context.
The sausage factory conundrum: One reason why hospitals seem to overcharge for certain procedures is to make up for the relatively little compensation they get for community and behavioral health patients. Until better reimbursement is provided, hospitals are forced to make up these expenses by increasing costs in other ways. Payment systems need to be more rational so pricing is more rational
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Role of employers: The role of employers came up a lot on the hangout. Elizabeth Mitchell, the CEO for the Network for Regional Healthcare Improvement, emphasized the critical role employers have in the transparency challenge. They have more power than they think to demand transparency from the companies with which they work.
http://www.youtube.com/watch?v=psK3D8Ih_HM
Apps: Consumer Reports won a RWJF transparency challenge for its Hospital Adviser app. Its app is designed to inform consumers seeking the best hospital for hip or knee replacement surgery. Consumers can include their experience and notes in one place. Chris Bailey, who is developing the app, said it’s currently in private Beta and would use feedback from users to tweak it.
States taking initiative
Arizona Department of Health’s website Arizona Price Compare compares prices for certain procedures across hospitals for 2011.
California’s Common Surgeries and Price Comparison is a website allowing healthcare consumers to view and compare the price of 28 common elective inpatient procedures at hospitals across California.
Florida set up a website that enables consumers to obtain data on hospitals’ charges and readmission rates.
Maryland’s Health Care Commission provides consumers with an online hospital pricing guide that lists, for each acute care hospital in Maryland, the number of cases, the average charge per case, and the average charge per day for the 15 most common diagnoses.
New Hampshire’s website gives prices for certain procedures based on age and whether the patient is insured or not.
New Jersey launched a website to help consumers make informed choices regarding price and quality of hospital services in New Jersey.
Oregon’s website “Oregon Pricepoint,” is sponsored and maintained by the Oregon Association of Hospitals and Health Systems and allows health care consumers to receive basic, facility-specific information about services and charges.
