Interview: Price, quality and the Amish

In a recent interview with Mark Hochstetler, M.D., vice president of clinical affairs with the VHA, we discussed the issues of price and quality transparency and the effect that these trends are having on the healthcare industry. There have been quite a few price and quality transparency initiatives lately, driven by the current administration's support of CDHPs. Dr. Hochstetler noted that while this has caused quite a stir in the healthcare industry, it has had very little impact on patients. In fact, when Tufts HealthPlan posted provider quality information on its Web site, they found that a very small percentage of enrollees looked at the information but that 100 percent of providers looked at the data. The fact of the matter is, while CDHPs may be the wave of the future, most patients aren't paying attention to price and quality data because they simply don't have a reason to yet. When it comes to elective surgery, people are more likely to hunt for this data but (especially in emergency situations) most people don't care whether they make it to a five-star hospital or not. In addition, much of the data posted is confusing to a lay person, incomplete and can be misleading.

There is one group, however, that has effectively negotiated prices based on this data. If you want to see the future of healthcare, look no farther than…the Amish? Believe it or not, the Amish drive a hard bargain. They have become very prudent consumers and want good pricing because don't believe in personal insurance. This group may serve as an example of what will happen if high-deductible health plans become the standard means of insurance in the future.

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