Maryland launches healthcare cost and quality site for residents

Maryland is the latest state to launch a website that allows residents to find out the cost and quality of certain medical procedures at the state's hospitals in an effort to promote consumerism and transparency.

The website Wear the Cost, which went live Thursday, was developed by the Maryland Health Care Commission. Residents can look up the average total cost of four non-emergent procedures at Maryland hospitals. The state calculated the quality of care for those procedures by breaking down how potentially avoidable complications like infections, blood clots or pressure ulcers factor into the total procedure cost. "Putting those complications there is really very, very helpful," said Bob Moffit, chairman of the Maryland Health Care Commission. "It enables people to make appropriate decisions." The data is from Maryland's all-payer claims database, which includes private insurance claims at the state's hospitals. Medicare claims data will eventually be included as well. The four procedures currently on the site are hip and knee replacements, hysterectomies and vaginal deliveries. Those procedures were included because they are usually scheduled in advance so consumers have the time to shop around before choosing a facility to get their care, said Ben Steffen, executive director of the Maryland Health Care Commission. The state plans to add more procedures to the site over time. The commission hopes residents will use the site to be smarter healthcare shoppers, Moffit said, noting they are trying to make it "as easy as possible" for people to find out cost and quality information. The site shows how the facilities with the most expensive procedure costs don't always offer the best quality. For example the site shows that the average total cost of a knee replacement at Medstar Harbor Hospital is $37,225 with $1,097 of the cost accounting for potentially avoidable complications. The site also shows that the average total cost of a knee replacement is $22,687 at the University of Maryland Shore Medical Center at Easton, and just $353 accounts for potentially avoidable complications. "Just because you pay more for a procedure doesn't mean that it's better quality," said Marilyn Moon, former chair of the Maryland Health Care Commission. MedStar said in a statement that the website is "potentially confusing" because it includes data on entire episodes of care. The data, from 2014-15, also doesn't reflect changes that have been made at MedStar, the statement said. For example, MedStar Good Samaritan Hospital no longer performs hip and knee replacement surgeries. The site also highlights how the cost for a procedure can vary by thousands of dollars depending on the facility. The site shows that the average cost for a hysterectomy in Maryland is $16,381. But Johns Hopkins Hospital is above that cost with an average of $20,010 for a hysterectomy. In response to the website, Johns Hopkins said, "We fully support any efforts aimed at providing transparent information to help patients make informed decisions. We believe that the current site does not yet achieve that goal. We will continue to work with the Maryland Health Care Commission to better understand the data and methodologies they employed, as well as advocate for the inclusion of additional information that would assist patients in making the right choice for health care services." The hospital also added that its obstetrics and gynecology team treats the most complex patients in the region. Although consumer-friendly sites that provide cost data are no longer a rarity in healthcare, they often aren't widely-used or popular. Consumers shopping for healthcare is still a subset of the population and site creators usually struggle to get funds for marketing and outreach. Maryland hopes to draw residents to the site through social media campaigns and with the help of consumer advocacy groups. Moffit added that resident use of the site is only one piece of the puzzle. He thinks the site will encourage providers to lower their own prices. No facility wants to be the most expensive when the information is so publicly available. "Physicians at the hospitals themselves will compare themselves to other folks and make adjustments," he said. An​ edited​ version​ of​ this​ story​ can​ also​ be​ found​ in​ Modern​ Healthcare's​ Oct.​ 23​ print​ edition.