CMS Contractors ’ Survey Research Illustrates Four Health Care Transparency Paradoxes

This article identifies what might be called four health care transparency paradoxes — aspects of HHS transparency communications in which assumptions are contradicted by what consumers have told researchers. Assumptions of HHS Health Care Transparency Tools The goal of health care transparency is to drive consumers to providers with high quality and efficiency, thereby improving outcomes and reducing resource use. For instance, when a patient is diagnosed with end-stage renal disease, the assumption is that the patient will visit the Dialysis Facility Compare website, look at quality indicators, and choose a clinic based on those indicators. Similarly, a patient for whom joint replacement surgery is recommended would visit the Hospital Compare website to look at quality indicators and then choose a hospital at which to undergo the procedure. As such, transparency as envisioned by HHS embraces what is sometimes called the consumerist approach to health care, in which competition in the market occurs at the level of the individual provider. Porter and Teisberg argue that competition “should occur in the prevention, diagnosis, and treatment of individual health conditions or co-occurring conditions. It is at this level that true value is created… [a]nd it is here where competition would drive improvements in efficiency and effectiveness, reduce errors, and spark innovation.” An alternative approach, managed competition, invites consumers to choose an insurer/provide...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Featured Payment Policy CMS HHS Price Transparency shoppable services Source Type: blogs