News and Insights
Six Actions to Prepare for a Transparent World
Greater transparency is coming to the healthcare delivery industry. The current spotlight is on the new (and controversial) overall hospital quality ratings from the Centers for Medicare and Medicaid Services (CMS) – but the introduction of this rating system isn’t just a passing fad, it’s a sign of the times.
Consumers can already access key data points and overall ratings through government sources like Hospital Compare and Physician Compare, third parties like HealthGrades, Leapfrog, and Consumer Reports, insurance companies’ cost estimators, and a growing number of other websites and apps. CMS has begun to publish data annually on Medicare payments to hospitals for the most common 100 DRGs.
Additionally, most states have active health price transparency and price disclosure legislation, ranging from requiring hospitals and other providers to report prices to state health agencies to requiring providers to inform patients of prices for common procedures. A growing number of states have also created all-payer claims databases (APCD) that offer guidance to patients about the costs for common treatments in a way that encourages comparison among facilities.
The challenges posed by the growing demand for transparency will require advance planning, new investments, and new ways of conducting the business of caring for patients.Read More
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