Reporting Provider Costs to the Public

The Agency for Healthcare Research and Quality attempts to prepare comprehensive assessments of the research on various approaches to improving the health care system.  A recent report looks at the status of efforts to raise the public’s awareness of the costs of services.   (AHRQ Report)   The “consumerism” movement is founded on the premise that if people know prices of services, they can make choices that maximize not only their health but their financial status.  The primary focus of the report was an “environmental scan”–an ascertainment of current practices.   The researchers examined 59 websites which purported to provide cost data.  Three-quarters of these were operated by state departments of health or a state hospital association and about a similar percent gave only average charges.  Very few reported out-of-pocket costs or current year data.  Among the problems identified by the authors are lack of consistency in the data, failure to use measures that reflect both cost and quality, inappropriate comparisons, lack of awareness of data sources by consumers and an inability for consumers to give feedback on the usefulness of the data.  It is apparent that we are a long way from being able to give health care consumers clear, accurate and actionable cost and value data; much less being able to engage and motivate them in using that data.  Several private companies and a number of health plans are working on this area; one notable recent announcement was that the Health Care Cost Initiative will work with several major payers to provide detailed provider costs to the public.  Public reporting on quality measures has largely been a disappointment, since it does not appear to improve ultimate outcomes and consumers don’t appear to use the data.  The premise is sound, but getting public reporting of quality and cost to a point where it makes a difference in how consumers act is not easy.