Rising health care costs are raising the stakes for consumers in selecting the right health plan and provider to meet their needs. As a result, consumerism in health care is rapidly evolving, supported by improved tools via data and information technology, new plan designs, and the growing role of online comparison shopping in our everyday lives.
To improve enrollment and get a handle on costs, policy makers in Congress and the Administration need to use data and tools more effectively. Better management of federal and state programs increasingly means decision makers must keep up with the latest tools, trends, and capabilities. Demand for these tools is robust and growing across demographic groups.
Millennials in particular are more prone to expect “instant gratification,” now that online information is at their fingertips 24/7 through mobile devices. Unlike previous generations, millennials tend to be more cost-conscious and value on-the-go convenience — 41 percent said they were likely to preemptively ask for health cost estimates, and 71 percent would welcome tracking health care items like records and doctor’s appointments via mobile app.
While the reasons may vary, the need for more information is a constant across all generations. We need greater transparency in the health care system so that all Americans can make more informed decisions that improve health outcomes and lower costs.
There are obvious signs that the health care system and federal government have been too slow to adapt to the changing dynamics and growing demand for transparency in health care. Several issues continue to frustrate federal data policy that would contribute to better data, better tools, and better markets for consumers making decisions about their health care and coverage.
For example, federal health programs still allow for information blocking by Electronic Health Record vendors and consumers are often misled with confusing jargon and apples-to-oranges comparisons.
In response, the Clear Choices Campaign is calling for concrete improvements from the Department of Health and Human Services (HHS), including:
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Improve Quality Reporting Data: By 2017, HHS should strengthen health care quality measurement and reporting — increasing its relevance to consumers and decreasing its burden on providers. Quality measures should account for public health impact, link to improvement in patient outcomes, and address gaps in care.
Make More and Better Data Available to Consumers and Entrepreneurs: HHS should increase the availability of health care data — such as claims data for Medicaid and the Children’s Health Insurance Program (CHIP) — in standardized formats for developers, researchers, and consumers.
Such data should be provided for public good as a by-product of taxpayer investments in federal health programs.
Collaborate with Private Sector Data Transparency Efforts: HHS should recognize and encourage further dialogue with private sector third-parties engaged in improving health care transparency. The Department should build upon the private sector’s ongoing initiatives, experience, and lessons learned in health care data infrastructure and sharing.
Increase the Relevance of Data for Consumers: HHS should collaborate with providers and employers to present consumers with relevant health care data. Consumer-facing information should be accurate, valid, evidence-based, and reliable, and should be presented in plain language and in a user-friendly format.
Strengthen Patient Data Access: HHS should establish standards to support comprehensive patient electronic data portability. Patients should be able to take their entire EHR with them when seeing other providers.
Streamline Exchange Enrollment Websites: HHS should continue improving the consumer-facing features and tools on HealthCare.gov for plan year 2017. Such tools could include virtual assistants to help consumers understand the pros and cons of different plan choices.
Clear Choices believes that optimal federal data policy requires a national strategic framework for HHS transparency and public data sharing. Including the recommendations above in such a framework would guarantee greater buy in from stakeholders and lead the Administration’s transparency efforts toward a consumer-friendly health care environment.
If implemented, we believe our recommendations would strengthen and modernize HHS data sharing policy in a way that would resonate with the public.
Photo: Flickr users Alan Levine
