Report: Health Care Pricing and Quality Transparency Still Needs Improvement

August 21, 2007 ( - Quality transparency in health care service is far greater for hospitals than it is for individual physicians and pricing transparency is still in its infancy, according to a recent report from the National Business Coalition on Health (NBCH).

The NBCH report used a method called eValue8 to assess what health care providers were doing to advance U.S. Department of Health and Human Services (HHS) Secretary Mike Leavitt’s call for the transparency of price and quality incentives for high-value health care and interoperable health information technology (HIT).

The evaluation was meant to encourage health plans to meetLeavitt’srequest for health care providers to share information with consumers about the quality of physician care, the study said.

According to the report, more than a quarter (26%) of plans say they report patient experience information to consumers, and the same percentage say they report whether physicians have attained recognition from the National Committee for Quality Assurance.

Only 6% report on available measures for specific conditions such as heart problems and diabetes; however, 30% say they use available condition-specific measures to report hospital performance for conditions such as heart attack and pneumonia.

Some 33% of plans pool information with other plans using AQA measures (formerly known as the Ambulatory Quality Alliance). Bringing together this information enables reporting about more physician practices and makes the data much more reliable and useful to consumers, according to the report.

Eleven percent of plans collaborate on the use of hospital performance measures from the Hospital Quality Alliance (HQA). eValue8 asks plans if they use the HQA measures when evaluating hospital performance. Almost 50% of health plans use at least one HQA measure, but none use all of the standards.

Hospital Performance

The data also show that health plans publicly report more information on hospital performance than they do on physician performance.

The data show that 41% of health plans use health information technology (HIT) interoperability standards for 75% of more their enrollment and eligibility transactions. Among plans, 27% make substantial use of interoperable HIT standards for claims and encounter data, and 18% accept lab results electronically.

The eValue8 data also show that consumers have access to HIT applications online from their health plans. Many plans (81%) have HIT applications that help consumers make treatment decisions, 64% help patients monitor chronic conditions, and 64% allow members to create and view personal health records online.

Other results from eValue8 show that:

  • Less than 5% of health plans exchange clinical information by transmitting pharmacy data.
  • Less than 10% of plans promote electronic health record (EHR) vendors certified by the Certification Commission for Healthcare Information Technology (CCHIT).
  • Less than 10% provide a financial incentive to providers to use CCHIT-certified EMRs.
  • Less than 5% provide any public recognition of physicians who have such systems.
  • Use of electronic records is important because such information forms the basis for clinical decision support, coordination of care, patient tracking, patient safety, and practice performance reporting.

NBCH member coalitions analyzed eValue8 data from nearly 200 providers in 44 states.

For the full report visit .