Quality transparency needed along with price transparency, and other letters

Regarding the recent cover story on price transparency titled “Revealing times”, the game-changer in all of this is the huge increase in the number of people who woke up Jan. 1 with a large deductible built into their health insurance. And, according to Mercer's National Survey of Employer-Sponsored Health Plans, this trend is going to continue.

While this hasn't received that much press, it is, as the article notes, a key driver in the price-transparency movement. After all, despite industry euphemisms such as “the empowered healthcare consumer” and “consumer-directed health plans,” most people are simply ill-prepared and ill-equipped to take the leap into shopping for and buying healthcare services.

The healthcare industry as a whole needs to embrace not only price transparency but quality transparency as well. While it might sound like heresy, this is the only way to meet the needs of the new healthcare consumer. Payers and providers can choose to ignore it and hope it goes away, or take the lead.

David Schultz

Regarding the story “AMA fears privacy loss as Medicare moves to reveal doc pay”, I'm assuming that the rationale behind this is to make it easier for investigative reporters to find abuses, which I guess is OK. Hopefully, they'll also start posting what Medicare pays for prescription drugs and various procedures such as colonoscopies.

When I started searching for a provider, I found a fourfold difference in facilities fees between a physician-owned endoscopy center and that at a large health system. A little public outrage (preferably a lot) over these fee structures would be a good thing.

Dr. Gary Steven

Regarding “AMA fears privacy loss as Medicare moves to reveal doc pay,” it's not clear if the reimbursement amount per physician is total payments in aggregate or broken down by the numbers of each type of exam or procedure. The general public has no concept of overhead, medical-malpractice premiums, nonreimbursed expenses, employee salaries and benefits, licenses, continuing education, or even how much sleep a physician gets. All they know is that when they call the answering service at 2 a.m., they expect a return call within 5 minutes—and they don't expect to be billed for that time.

I bet they don't abuse their attorney with calls at all hours, where they do charge by the clock.

Lawrence Jankowski

Regarding the story “Healthcare employment drops for first time in decade”, while at first sight I was shocked by the fact there's a decrease in an industry booming with opportunities, looking at the fact outpatient ambulatory-care hiring ticked up 30% above average numbers tells me folks are leaving the hospital for the office. It's a move I believe stems from the uncertainty hospital administrators place on their staff due to CMS changes, threats of overutilization penalties, shrinking margins from competition, quality of life, etc.

With the Affordable Care Act expansion placing more opportunity for private practitioners and ancillary groups to profit from the new generation of insured, the hiring pools are expanding for those not wanting to be part of a larger institution.

Michael Dew