How does the Quality and Cost Council go about providing consumers with information that they can use to make intelligent decisions about their health care choices? The answer is, With Great Difficulty.
It is unbelievably hard to turn data into information, and getting the data in the first place isn’t all that simple.
Let’s say you want to tell consumers which hospitals are the least expensive. First, you need to find out what hospitals charge — and for what services. Then, it turns out that different purchasers pay different prices. Sticker prices aren’t real because hospitals have different arrangements with different payers, and these arrangements can include not just discounts and daily charges, but also extra payments for special services or meeting certain contractual goals. So even if you collect all the claims with all the charges for all the payers, no mean task just by itself — what numbers do you choose to display? The average charge? The average amount actually paid? The average amount paid by the patient? The insured patient? The uninsured patient? Medicare? The Group Insurance Commission? With bonuses, without?
And which of those numbers does the consumer really want to know?
Or need to know? Some people say that the patients don’t care about anything but their out of pocket costs, and there’s probably some truth in that — but in the long run, their premiums next year will be affected by the bigger piece of the bill their insurer pays this year, so maybe we need to tell the whole story.
The Quality and Cost Council is just beginning this awesome task of collecting the data. The hard part — the work of analyzing and arranging the data so that it becomes usable information — lies ahead. All of this effort is just one piece of the Health Care Reform Act — and the pieces, like pieces of any puzzle are all important if you want to see the whole picture. However, complex the cost data may be — the information we will get from the work of the Quality and Cost Council can help in getting a handle on the larger healthcare cost problems, problems which we have to solve if we are to keep the promise of Reform.
Dolores L. Mitchell, Executive Director of the Group Insurance Commission of the Commonwealth of Massachusetts, the agency that provides life, health, disability and dental and vision services to over 285,000 State employees, retirees and their dependents.
This program aired on December 3, 2007. The audio for this program is not available.