During 2006, employers [1], managed care plans, trade groups [2], state governments and federal agencies [3] took a new and aggressive role in bringing pricing and outcomes data to the public, in many cases by posting aggregate hospital and physician data to publicly-accessible websites. In fact, for many providers, 2006 was the year in which turning over pricing and quality rating data to the public stopped being a courtesy and started being a core requirement of doing business. Several states, including Texas [4], Maryland [5] and Massachusetts, have taken a leading role in this effort. Massachusetts, for its part, went so far as to publish performance data [6] on individual cardiac surgeons' performance.

While providers have wrestled with managed care plan quality ratings for many years, in the past such ratings were mostly a behind-the-scenes contract negotiation issue. This year, however, millions of providers had their pricing and performance data posted in the public square. Sometimes this has provoked angry wrestling matches, as in Texas, where doctors are fighting their local Blue plan's efforts [7] to publish individual doctor ratings.

Still, it's telling that with most transparency efforts launching this year, no one has had a meltdown, predicted doom or threatened to sue. Even if they find fault with the way a particular transparency project is handled, most providers seem to accept that they're going to face a new level of scrutiny in coming years. Like it or not, this is where the industry is headed.