Why Healthcare Transparency is the New Name of the Game

Why Healthcare Transparency is the New Name of the Game

The Trump Administration’s campaign promise to advance healthcare transparency couldn’t be more timely. Pressure is mounting on healthcare providers to give price and quality information to consumers, and to improve transparency around payments from pharmaceutical and medical device companies. In 2015, about half of the doctors in the U.S. received payments from prescribing and using brand named drugs and devices, totaling nearly $2.4 billion.

Efforts by individual states to improve transparency have not gained much traction as of yet, either, so it’s no surprise that most states actually received a failing grade in a report card on transparency laws published by two nonprofits: the Health Care Incentives Improvement Institute and Catalyst for Payment Reform.

There are compelling reasons for the industry to strive for more transparency on a national level. One reason is the overall competitive market landscape. Transparency between markets supports greater competition, and greater competition results in better quality and typically, lower prices. It could also help level-set some of the more extreme price and quality variances between markets.

Comparison Tools Are Put to the Test

The states of Tennessee and Kentucky launched transparency tools to help consumers determine the true cost of a procedure before getting it done. The tool provides pricing information for providers across the metro area, as well as hospital rankings and links to other provider websites so consumers can more efficiently comparison shop.

For consumers, transparency means they have better access to the information they need to make more informed decisions along their care journey, including more effective reviews of various providers, and potentially soon, reviews between cross-state market offerings.

Does Transparency Really Reduce Healthcare Costs and Improve Quality?

While early studies from 2012 demonstrated a low patient engagement rate in comparison tools, and therefore, lackluster results, more recent studies from a 2014 JAMA study look far more promising. The study found that medical spending decreased after employees were given access to a transparency tool, most significantly for lab tests and imaging. Another study from Health Data Management claimed that a pricing transparency tool saved one employer $1.1 million in claims.

Quality assessment tools have also been launched, but the equation to assess quality accurately and consistently is a complex challenge. The Federal government has attempted to standardize quality using metrics set by the Centers for Medicare and Medicaid Services, however, that data is difficult to understand, even for healthcare industry professionals.

Other Tools and Programs Offer a New Transparency Twist

As healthcare costs continue to rise with consumers footing more of the burden for higher premiums and out-of-pocket co-pays, they will in turn spend more time ensuring they get the best value for their hard-earned dollar. That means taking extra steps to compare cost, quality, physician access and hospital rankings, so healthcare institutions and practices that help them cut through the clutter with clear answers will propel ahead of the competition.

Service organizations such as NRC Health are helping healthcare organizations publish verified patient experience ratings and reviews to provider profile pages in consumer-friendly formats that help drive purchase decisions. Providers can publish star ratings to their websites, review patient comments, monitor consumer voice and tone across the web, generate provider scorecards and more.

Healthcare tools such as Medical Memory, a HIPAA compliant video messaging app, give providers and patients the ability to streamline and simplify patient communications by delivering personalized content via video. Such video communications throughout the healthcare journey are proving to improve patient satisfaction while reducing readmissions and malpractice risk.

What Patients Can Do to Encourage Healthcare Transparency

  • Ask their doctor if a drug is really necessary.
  • Request for visits and care instructions to be video recorded for future reference.
  • Leverage transparency tools provided by providers and institutions.

Healthcare transparency is here to stay, and only going to get more urgent in the months and years ahead. Institutions and physicians that embrace tools, programs and processes that empower transparency will stay ahead of the game, and ultimately, it’s the U.S. consumer that will reap the real rewards.

For more on how your institution or medical practice can improve transparency and competitive differentiation, reach out to a Medical Memory.