Hospitals, Policy

One tricky thing about transparency in healthcare is the piecemeal process

In Deloitte’s weekly healthcare industry insights this week, Dr. Harry Greenspun, a senior adviser at […]

In Deloitte’s weekly healthcare industry insights this week, Dr. Harry Greenspun, a senior adviser at Deloitte Center for Health Solutions, poses an important, lingering question about transparency: What are the implications of only having some transparency in healthcare?

Companies like PokitDok, Change Healthcare and Castlight Health have been winning over investors with their solutions for putting more information in the hands of consumers. Government, too, is making an unprecedented push to promote transparency in healthcare.

Last week, the Centers for Medicare & Medicaid services continued that push, quietly announcing that it would begin to evaluate requests for disclosure on individual physician payment information on a case-by-case basis.

While true transparency holds the promise of enabling more informed decision-making, Greenspun noted that this reimbursement information, for example, is one small, isolated piece of the puzzle:

“The challenge with transparency is that a complete picture often cannot emerge through one data point from a single data set (e.g., reimbursement). Instead, stakeholders get a cluster of data from one source at a time, typically without sufficient context to be insightful: a little cost here, a little quality there. This is a common issue in health care: programs rank providers based upon outcomes and then critics charge that the data is not risk-adjusted; cost of care is of great concern to consumers, but equally, consumer ratings of hospitals typically reflect their service experience.

Greenspun equated navigating the complex healthcare system to driving a car: There are several mirrors, but there’s still a blind spot. And even those mirrors come with warnings. In the case of healthcare, it’s important to consider that the small pieces of transparency we see may not reflect the whole reality.

Yet, he wrote, some information is better than no information, and waiting for all of the necessary information to become available is not an option:

“As we move to slow the growth in cost of health care, each new element of transparency we add is an important step. So, we shall see what warnings come with this new information. But, we’ll also look toward the day when the full spectrum of information is available to us, helping us move forward and, perhaps, automatically preventing us from getting into an accident.”

Read his thoughtful commentary here.

[From Flickr user John Lemieux]

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