Transparency in Healthcare?

Last Updated Jul 24, 2007 3:25 PM EDT

Last year, the Department of Health & Human Services (HHS) launched the Value-Driven Health Care initiative to create "transparency" in the heatlhcare system to drive down costs and improve quality of care. HHS is looking to American businesses to take an active role, and in the year since the initiative launched, more than 700 employers have signed up. In addition to the expected healthcare-related companies like Anthem Blue Cross and Blue Shield, you'll find Exxon Mobile, Ford Motor Co., FedEx, and a host of other easily-recognized names. Participating employers agree to support "the four cornerstones" of the initiative:
  • Support Health Information Technology
  • Provide Quality Information
  • Provide Pricing Information
  • Promote Quality and Efficiency of Care
Among its goals, the HHS wants standardized electronic health records to more easily gather nationally-accepted quality of care measures from providers. Participating employers must "request" that their healthcare-related contractors choose HHS-approved health information technology. The information would be made available to the public. But even the initiative's web site points to a barrier:
The health care "system" in America is not a system. It's a disconnected collection of large and small medical businesses, health care professionals, treatment centers, hospitals, and all who provide support for them. Each player may have its own internal structure for gathering and sharing information, but nothing ties those isolated structures into an interoperable national system capable of making information easily shared and compared.
And, although it's not mentioned on the site, employers face the problem of getting their employees to care about pricing information (cornerstone three), even if it's easily available. ('Fess up: When was the last time you pored over an Explanation of Benefits from your insurer?) While insurers in the initiative are experimenting with pay-for-performance to drive quality outcomes on the provider side, the benefits to the consumer seem harder to capture. According to the site:
What if, when going for an elective treatment such as a knee replacement, you are given options: health care professionals who provide high quality at high costs; those who provide low quality at low costs; and everything in between? Suddenly, you have information you need and a personal incentive to care.
When buying a car, folks may go for the lower quality/lower cost option, but that's a tougher sell when it's your body and health. "People need to care about price and quality," the site proclaims. Yes, they should, but will the transparency promised by the initiative be enough to make them even pay attention, much less care? And, if they don't, what is the next step for employers to take?