The newly formed Center for Healthcare Transparency (CHT) has an ambitious goal--it wants half of the U.S. population to have access to reliable cost and quality information by 2020. But panelists at Friday's event to unveil the new initiative at the National Press Club in the District of Columbia said the healthcare industry's current transformation make now an ideal time to pursue such an effort.
One of the main reasons that Niall Brennan, the chief data officer for the Centers for Medicare & Medicaid Services (CMS), believes the time is right to create a national transparency initiative is the fact that so many more healthcare stakeholders have taken an interest in the subject.
"A few years ago, you could've put everyone interested in transparency in a closet, and there would've been room left over," he said.
Industry pushing for transparency
CMS itself took a major--if controversial--step in this direction Thursday when it released data on Medicare Part D that indicated the program spent $103 billion on prescriptions in 2013, FierceHealthPayer reported. The American Medical Association has sharply criticized the move, writing in a statement that it is "troubled by the lack of context provided with that could help explain physician prescribing practices and pharmacy filling practices before conclusions are drawn."
But the issue of price transparency alone gained increasing importance in the healthcare industry due to the proliferation of medical options and the rise of consumerism, FierceHealthFinance reported.
Perhaps an even bigger factor driving the push toward overall transparency is the industry's shift to value-based payment models, a subject several panelists touched on. David Lansky, CEO of Pacific Business Group on Health, a large insurance purchaser, put it simply: "If we're going to pay everybody based on value, we better be measuring it in a sensible way."
To achieve this goal, the CHT plans to leverage the work done by existing transparency projects from regional organizations that represent patients, providers, insurers, employers and public purchasers, according to a statement from the Network for Regional Healthcare Improvement (NRHI), one of the key partners in the initiative.
Rather than simply allowing these projects to continue in a vacuum, "we believe now is the time to take this to scale, because we believe we cannot transform our system without transparency," said Elizabeth Mitchell, president and CEO of NRHI. This latest effort to drive transparency is particularly strong because it draws on public and private stakeholders as well as regional and national organizations, she added.
Data governance, exchange, privacy pose challenges
Panelists also identified some of the roadblocks that they envision the CHT will face, the biggest of which may well be data governance, according to Mylia Christensen, the executive director of the Oregon Health Care Quality Corporation, a nonprofit organization that produces healthcare quality and cost information and is designated as a "Qualified Entity" program by CMS. Christensen, however, said she views this as both a challenge and opportunity.
Indeed, large-scale data exchange "only happens at the speed of trust," meaning it's critical to engage patients, providers and stakeholders at the local level to encourage the flow of information, said David Kendrick, M.D., principal investigator and CEO of the Oklahoma-based nonprofit MyHealth Access Network. His organization, one of 17 groups funded by the Office of the National Coordinator for Health Information Technology, works to strengthen the local health IT infrastructure, according to its website.
For its part, CMS has learned that "transparency is deceptively difficult, regardless of how you approach it," Brennan said, noting that patient privacy also is a key issue that the agency must take into account. "From the CMS perspective, people just think that there's kind of a magic switch that we press inside the building and data gushes forth."
CMS' work with various consumer websites like Hospital Compare also has taught it that understandability of information is vital to ensuring that it's useful, added Kate Goodrich, director of CMS' Quality Measurement and Health Assessment Group.
Mitchell also emphasized that the CHT is about more than just the free flow of information.
"We're not just doing this to collect data or come up with new measures--this is about changing care and making it better for everyone involved," she said.
To learn more:
- check out the NRHI statement
- here's the AMA statement
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