MHA's Executive Briefing

Congress Considers Three Health Care Pricing Transparency Bills

Late last week the House Energy and Commerce Health Subcommittee took up the issue of pricing transparency in health care and heard testimony on three bills that could change the way providers charge patients for services. While all three bills would establish baseline requirements for hospitals and other providers to disclose information about how much they charge and how much patients are expected to pay out-of-pocket, where the bills take different approaches is how they are administered (at the state or federal level) and the broadness of their scope.

Read more here.

The Limited Effects of Transparency

Traditional economics says greater price transparency leads to less price variation. A Center for Studying Health System Change report of hospitals and freestanding medical facilities in New Hampshire challenges that notion.

A Peek into the Power of Transparency

Did you ever wonder what an outsider can discover about the quality of care at your hospital? The results of this kind of Information Age prospecting provide a provocative peek into the power of transparency.

For the full story, click here.

Bill would make U.S. hospital infection rates public

Over the past week or so, the mainstream news media have crackled with the news of staph infections (including MRSA) found in community schools. Prompted by this, Rep. Tim Murphy (R-PA) has filed a bill that would require all hospitals in the U.S. to report infection rates to HHS. Under the terms of the bill, HHS would make such information available publicly on its website.

Such a measure would trump existing infection tracking underway in the states. 

To learn more about the bill, read this Pittsburgh Post-Gazette article.

[ via FierceHealthcare ]

Study: U.S. health consumers demand transparency

Pushed by the growth of consumer-driven health care plans, consumers have begun to expect - often, to demand - detailed data from providers. Nearly 85 percent of consumers responding to a new survey said that they believed hospitals and doctors should be required to disclose their prices. And more than half of those responding said that they'd be influenced by such pricing information, according to the survey, which was conducted by the PNC Financial Services Group.

The same survey found that consumers are struggling with claims payment issues - for example, it found that six in 10 consumers didn't know that there's a limit on how long they have to dispute claims denials.

To learn more about the study, read this PNC press release.

[ via Fierce Healthcare ]

Price transparency

Rising health care costs, combined with plans that require higher deductibles, have forced consumers to be more fiscally aware of hospital charges. Patients are investigating facilities and determining which ones offer the best rates for various in- and outpatient procedures.

In response, hospitals have started to answer the call for pricing transparency. To do this effectively, however, hospitals first must understand what information consumers want, and how they are going to access it. Oklahoma's Integris Health has created a hot line and a Web site for patients that clearly spell out the price of care and what patients get for their money.

Read the full article from H&HN Online.

Value innovation to win in healthcare

Health care organizations face tremendous change in the next decade. A significant driver of this change is attributable to consumers who are increasingly responsible for their healthcare purchases. Consumers are seeking value—the axis of service, results and price. Healthcare can learn much from the retail industry, which operates in an ever more value-driven environment. The shift to a value orientation will require innovation of healthcare's business models, operations, services and markets. Organizations that embrace value innovation as a culture and strategy and execute changes effectively and rapidly will win in a value-driven market.

Read part one and part two of the article by Brian McDonald from HealthLeaders Extra. 

Simplified finances empower patients

The old retail maxim that the customer is always right can be a peculiar notion when it comes to health care. In fact, just defining who the customer is can be difficult. Employers or insurance companies are usually paying the bills, but not receiving the services. Patients are getting the care, but not making many of the decisions. Technology vendors tend to follow the money, and typically deliver products that meet the needs of the institutions that write the checks, rather than the needs of consumers. But this may be about to change.

Read the full article from HHN MostWired.

Health care transparency bill introduced in House

American Hospital Assocation-supported legislation introduced Sept. 13 by Rep. Michael Burgess, R-TX, would require states to publicly report hospital charges for certain inpatient and outpatient services, and insurers to give patients an estimate of their expected out-of-pocket expenses on request. “America’s hospitals are working hard to share useful information, including information about hospital prices, that helps patients and consumers when making choices about their care,” said AHA Executive Vice President Rick Pollack. “That’s why we strongly support the Health Care Price Transparency Act of 2006.”

In addition, the bill would require the Agency for Healthcare Research and Quality to study what type of health care price information consumers would find useful and how it could be made available in a timely and understandable form. “This research is essential if we are to reach the goal of providing useful information that helps people make informed decisions about their care,” Pollack said.

[ via AHA News Now ]

Federal push for IT, transparency gets more steam

President Bush signed an executive order Aug. 22 requiring HHS, three other federal agencies and their contractors to use interoperable health information technology and standard quality measures and to be more transparent about healthcare prices, the White House said.

Meanwhile, the CMS said it has posted on its Web site Medicare payment rates and facility costs for 61 procedures performed in ambulatory surgery centers. The CMS also said it is expanding the scope of a six-state pilot project to provide consumers as well as public programs with better cost and quality information. Final contracts for the project, announced in February, are being finalized.

Speaking to business leaders about the government's IT initiative, HHS Secretary Mike Leavitt said he is asking the nation's largest employers to impose the same interoperability and transparency standards on healthcare companies with which they contract. "It's very important that the federal government isn't the only one doing this," Leavitt said. The executive order will apply to HHS, the Defense and Veterans Affairs departments and the U.S. Office of Personnel Management.

[ via Modern Healthcare's Daily Dose ]