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A LOFTY GOAL

September 1, 2006
by Douglas J. Edwards, Editor-in-Chief
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Late last month, President Bush directed federal agencies administering or supporting federal health insurance programs to make provider quality and price data more available to beneficiaries. He hopes states and private insurers will follow suit, eventually making such information available to all Americans. It sounds like a good idea on paper, but in practice I'm not sure what all that data would mean to consumers.

If asked, most consumers probably would say that they want access to price and quality data, but whether they actually would use that information is another matter. We certainly have plenty of data available to make decisions about 401(k) plans, but how many of us really study the markets and our quarterly statements to maximize our investments? Who has the time? If you are like me, you are baffled by the details and investment lingo, your employer did not provide much education, and you chose a plan with a lot of uncertainty.

Although the goal of the President's initiative is to boil down healthcare quality and price data into a “single, easy-to-use spreadsheet format,” that's not realistic in the short term. Most aspects of healthcare still are deciding how to measure quality. On page 64, representatives of the National Council for Community Behavioral Healthcare explain that we have a long way to go before we'll have agreement on quality indicators for behavioral healthcare (meaning the field is certainly not ready for pay-for-performance initiatives being floated by some payers). But on page 22 you can read about how the Joint Commission on Accreditation of Healthcare Organizations and its partners are defining quality for inpatient psychiatric environments.

I'm not sure how price data can be shared easily with consumers either. As you know, many factors go into determining what a particular service costs, how much a payer will cover, how much consumers are responsible for, etc. The government's experience with Medicare Part D does not give me hope that healthcare price information can be disseminated in a consumer-friendly format anytime soon.



Douglas J. Edwards, Editor-in-Chief
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