Choosing Wellness: Transparency in Health Care

Today, consumers must take an active role in their own health care and choose providers and hospitals who consistently deliver high-quality and high-value care. It's critical if we want to rein in spiraling costs and enhance care.
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The call was urgent. Having just moved to a new city, my good friend found himself in an emergency room with chest pains. Was the hospital good, he wanted to know? Could I recommend a cardiologist?

Because I am a doctor, friends and family often turn to me for guidance on health care. But the answers are found... where?

Luckily, my friend's pain subsided, but suitable answers to his questions lingered. It's shocking how little information is available to us to make important health care decisions. Obviously, when our health is threatened with acute illness, we don't have time to check all the facts on our doctors and hospitals. But the rest of the time we do, and we need to.

I'll confess, when I worked as a full-time physician, I may not have liked being quizzed by a patient about treatment options, costs or my compensation. I may not have wanted the quality of my care to be scrutinized, and made public. But that was a different era.

Today, consumers must take an active role in their own health care and choose providers and hospitals who consistently deliver high-quality and high-value care. It's critical if we want to rein in spiraling costs and enhance care, and if we want to achieve effective, life-long management of chronic conditions.

The good news is that widespread polling and focus groups show Americans are increasingly receptive to the idea of making informed choices. But to do that we need -- and deserve -- access to hard, cold facts about quality of care and its costs.

Fueled in part by efforts from the public and private sectors, the health care industry is quickly moving toward greater transparency. Employers who offer health insurance benefits, and cover more than 80 percent of the annual tab for their employees' health insurance premiums, are shrewder when it comes to selecting -- indeed, demanding -- coverage and quality care at affordable prices, and that's driving some of the change.

The Robert Wood Johnson Foundation has been a leader in helping communities measure and report the quality of care that local physicians and hospitals provide. By reviewing and acting on this information, consumers can make more informed health care choices, while exercising market forces on the health care establishment.

The foundation's Aligning Forces for Quality (AF4Q) initiative, focused on 16 communities that are pioneering improvements in health care quality and value that can be brought to scale, shows us that when the care of local doctors and hospitals is measured and publicly reported, care improves.

This is why it is so important that our federal government continues supporting programs that increase transparency in our health system. The Centers for Medicare & Medicaid Services recently named the first four participants in its Medicare Data Sharing for Performance Measurement Program, which will enable more information on the quality of care provided by local hospitals and physicians to be released publicly. Three of the organizations are participants in AF4Q: the Health Improvement Collaborative of Greater Cincinnati, the Kansas City Quality Improvement Consortium (serving the Greater Kansas City area in Missouri and Kansas), and the Oregon Health Care Quality Corporation. And the other, the Maine Health Management Coalition Foundation, is a committed AF4Q partner. That's a good start.

The government also must continue its Physician Compare program, which assesses the performance of local providers, and strengthen its Hospital Compare program, which assesses local hospitals -- and improve its efforts to make these programs known to consumers.

And finally, it's critical that the government insist that health insurance exchanges be focused on value. Discussion about public reporting programs in the exchanges should focus on what performance metrics insurers will use to report on the quality of the providers they cover, and how this information can be shared in clear and understandable ways with consumers.

Through our philanthropic work, the Robert Wood Johnson Foundation has learned a lot about how to effectively measure the performance of local health care providers and report the information to the public in ways that are clear. Thanks to recent actions in both the public and private sectors, consumers -- and policymakers -- can expect even greater transparency in the near future.

Risa Lavizzo-Mourey, M.D., MBA, is president and CEO of the Robert Wood Johnson Foundation, the nation's largest health and health care philanthropy.

For more by Risa Lavizzo-Mourey, M.D., click here.

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