“Quality information is important because, without it, consumers may mistakenly assume that higher cost services equate to higher quality services, when often the opposite is true,” says the four-page letter addressed to leaders of the House Ways and Means Committee. “We urge the committee to clarify that CMS data should be more widely available for government, nonprofit and commercial research.”
Signers of the letter to the House committee included the Boeing Co., Caterpillar, Dow Chemical Co., Xerox, UPS, and large interest groups such as the Council for Affordable Health Coverage, the National Coalition on Health Care, the Corporate Health Care Coalition, the National Retail Federation and the National Association of Manufacturers.
The healthcare industry already is seeing an unprecedented surge in data-gathering on healthcare, some of which is being made publicly available. Many states already issue quality-of-care rankings of hospitals, joining the growing number of private and consumer-rights organizations doing the same. Transparency is even coming to healthcare pricing, through insurers that publish prices to members and even states like North Carolina, which is beginning to publish price data.
“It's not just a trend, it's a tidal wave. People are suddenly interested in how much all this costs,” said Leah Binder, CEO of the quality-measurement organization the Leapfrog Group, who spoke about the importance of healthcare transparency though her group was not among the signatories to the letter to the House committee.
The Patient Protection and Affordable Care Act contained a few data-transparency improvements, but the business group's letter notes that the law was written at a time when the courts still held that releasing data on individual physicians' Medicare payments was a violation of doctors' privacy rights. That legal stance was reversed by a federal judge in Florida earlier this year, which should prompt a wider dissemination of data on prices, hospitals' costs, and clinical outcomes, the group said.
Francois de Brantes, executive director of the Health Care Incentives Improvement Institute, which did not participate in this week's letter, said federal officials still have not granted free and open access to Medicare's patient de-identified claims database.
“We should have access to these data in an unfettered way, especially since the ruling in Florida this year,” de Brantes said. “Even as a research organization, we have to pay” for what federal data are available today. “And it's not a negligible amount of money. You're talking about hundreds of thousands of dollars to gain access to these data.”
But wider dissemination of healthcare data could improve the system in many ways. For example, in 2012 the prices for cataract surgery ranged from $2,418 to $8,143, according to the International Federation of Health Plans. But it's not clear what value consumers get when they pay more.
Meanwhile, the healthcare reform law will leave more than 10% of all Americans uninsured—a population especially in need of transparent pricing information.
More information also could help in the hunt for healthcare fraudsters. The group noted that any doctors who bill 80% of their time to both Medicare and private health plans should come under investigation immediately, but that it's difficult to root out those providers without timely access to patient de-identified Medicare claims data.
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