To improve care quality and health outcomes and reduce costs for patients and families, our health care system must reward high-value care. Too often, we can’t assess value because health care cost and quality information is not transparent or accessible. We need to change that, so consumers, employers, health plans and policymakers have access to this information and can use it in a meaningful way.
In good news for patients and families, the federal government recently took two important steps to increase transparency. These actions exemplify a changing health care culture that recognizes the need for openness.
For the first time, the Centers for Medicare & Medicaid Services (CMS) released billing data for nearly one million physicians who provide services to Medicare beneficiaries. Medicare accounts for around $500 billion in federal spending annually, and Medicare beneficiaries, their families and taxpayers deserve to know how those dollars are being spent. Revealing the services providers bill Medicare for, and their cost, will allow us to determine value and better identify significant variations in cost and potential overuse of tests and procedures. This will lead to better care and health outcomes for Medicare beneficiaries and reduce costs for beneficiaries and taxpayers – a win for both.
CMS also announced that later this year it will begin using a five-star rating system to assess more than 4,000 hospitals that provide services to Medicare beneficiaries. On the website Hospital Compare, CMS already publishes quality performance information that includes patient-reported survey data on experience and the number of preventable readmissions within 30 days of patient discharge. While the availability of this information is significant progress, it is difficult for patients and families to determine a hospital’s overall performance or to compare one hospital to another. Using a five-star rating system will synthesize the Hospital Compare data into a composite score that can be easily understood by consumers. The introduction of a five-star rating system will help make quality information meaningful to consumers, while still allowing patients and families to drill down to more detailed information.
Both of these developments represent important progress in our ongoing efforts to increase the quality of care provided to patients, improve health outcomes and reduce costs for patients and families. While this transformation is incremental, our health care system is clearly changing for the better.