Imagine that it's Black Friday again.  You decide that because the Eagles are doing so well this season, you need a brand new 70-inch LED television.   You manage to shove your way past the crowd into Best Buy and find the television section.  There you see a wide range of televisions, each about the size you are looking for.  But there are no prices attached to them.  And no cards explaining their features.  And no store associates who can provide you with information or answer questions.  If that were to happen, you would probably storm out of the store, and try someplace else.

Unfortunately, that is exactly the situation most patients face in selecting health care.  They have little or no idea how much their care ultimately costs and often very little idea of the actual quality or features of the care they will receive.

But this lack in cost and quality transparency may finally be about to change.

On November 18, the U.S. Government Accountability Office released a report entitled Health Care Transparency: Actions Needed to Improve Cost and Quality Information for Consumers. The report, produced at Congress' request, critiques the current cost transparency measures under Medicare and makes several recommendations to help patients make the best decisions for both their wallets and their health.

Currently, the agency that runs Medicare, the Centers for Medicare and Medicaid Services, makes five transparency tools available for patients on its website: Nursing Home Compare, Dialysis Facility Compare, Home Health Compare, Hospital Compare, and Physician Compare.  Each allows patients to enter their zip code and compare characteristics of health care providers in their area.  For example, Nursing Home Compare presents comparisons of nursing homes' health inspection ratings, staffing, and quality ratings.

While these tools are a start, the Health Care Transparency Report highlights several shortcomings.  First and foremost, the tools do not inform consumers of their total out-of-pocket costs in obtaining specific services, which prevents them from comparing institutions and other providers based on price.  In addition, the tools fail to adequately summarize the descriptions and information for each provider, and do not permit customization of the information.

The Report makes several recommendations to improve the tools.  First, new cost and quality measurements and procedures are needed that focus more directly on the concerns and needs of patients.  Prime among these would be a tool for out-of-pocket cost comparisons. Another improvement would be relatively simple: listing the providers in the order of their performance on quality measures. The Report also urges CMS to develop a way to evaluate the tools' effectiveness in meeting patient needs.  Finally, the tools should allow patients to customize the information presented, which would enable them to focus on those data that are most relevant to them.

If CMS were to implement these measures, shopping for a doctor, hospital, or nursing home could be as easy as buying that 70-inch TV. Unfortunately, it wouldn't guarantee that the Eagles beat the Cowboys every time.


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