Healthcare transparency

Case study: Nurses offer cross-language care

Mon, 09 Jul 2007 20:01:35 -0400

Virtually every hospital faces at least some issues in working with immigrants who don't speak English. That's particularly true in states that face a particularly large flow of new immigrants, like California. Hospitals there are responding with new programs to meet the steadily increasing demand.

At UC Davis Medical Center, for example, they're handling the problem by establishing a special program designed to connect bilingual nurses with patients who need them. Under the center's Transcultural Linguistic Care Nurse Program (known as TLC), bilingual nurses conduct admissions interviews, interpret for physicians and work with patients. These nurses add to the medical center's existing capabilities, which include use of hired interpreters, translating phone services and the use of non-clinical bilingual staff members. To date, only five nurses have been assigned to the program, but hospital executives hope to add more.

To learn more about these programs:
- read this piece from the Sacramento Bee

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Study: OB/GYN fees vary up to 2,200 percent

Sun, 24 Jun 2007 20:01:34 -0400

New research suggests OB/GYN fees and availability vary substantially across the United States. According to research by healthcare comparison shopping site Vimo.com, average OB/GYN DRGs can vary by 2,200 percent depending on the zip code in which the physician is based. The group looked at specific DRGs and compared them across the country. For example, DRG 358 (Uterine & Adnexa Procedure for non-malignancy CC) cost was $4,123 in Salisbury, MD, but cost $91,637 in Modesto, CA. Along the way, the study also noted California has the largest number of active OB/GYNs of any state, with 6,147. At the other end of the spectrum, the District of Columbia has 204. It also found there are still twice as many male as female OB/GYNs, but reported the number of graduating male doctors is declining while the number of graduating female doctors has increased.

To get more information on the study:
- read this Vimo.com press release
- download the report (.pdf)

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Study: U.S. health consumers demand transparency

Tue, 12 Jun 2007 20:01:35 -0400

Health price and quality reporting may have started out a trendy insider notion, but it looks like those days are firmly over. Pushed by the growth of consumer-driven healthcare plans, consumers have begun to expect--often, to demand--detailed data from providers. Nearly 85 percent of consumers responding to a new survey said that they believed hospitals and doctors should be required to disclose their prices. And more than half of those responding said that they'd be influenced by such pricing information, according to the survey, which was conducted by the PNC Financial Services Group. The same survey found that consumers are struggling with claims payment issues--for example, it found that six in 10 consumers didn't know that there's a limit on how long they have to dispute claims denials.

To learn more about the study:
- read this PNC press release

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BCBS of Texas rolls out physician rating site

Sun, 20 May 2007 20:01:37 -0400

Hanging tough in the face of furious physician criticism, Blue Cross and Blue Shield of Texas has kicked off a program allowing beneficiaries to compare physician ratings. The health plan is the largest in the state, with more than 40,000 participating physician and 3.4 million beneficiaries, so its decisions have a significant effect on the market as a whole, making the ratings a major issue for the state's doctors.

The BCBS quality score currently uses 38 measures, and will add 12 more measures next year. Alongside their listing in the provider database, physicians get either a light blue ribbon or dark-blue ribbon based on their quality and affordability ratings. Consumers access the ratings through the site's physician-finder feature.

While it wouldn't halt its plans entirely, the health plan has attempted to calm physicians by making some shifts in its approach. After talking with doctors, the plan agreed to change its ranking system somewhat, removing a grey ribbon it planned to use to designate physicians who don't perform well or couldn't be ranked due to a lack of data.

To get more detail on the controversy:
- read this Dallas Business Journal piece

Geisinger offers flat-fee surgery package

Wed, 16 May 2007 20:01:37 -0400

Geisinger Health System is seeing some success with an intriguing experiment in packaging up services at a flat fee. Following a model pushed by proponents of "value-driven" healthcare, Geisinger has established a flat fee for some surgeries that includes not only follow-up care, but also treatment for any complications that arise. The program, which focuses on elective heart bypass surgery, has been in place since February 2006. To make sure they didn't end up providing lots of extra care, Geisinger doctors identified 40 essential steps to follow, then set up procedures to make sure everyone followed the steps at all of the system's three hospitals. Over time, Geisinger has found that patients are less likely to return to the ICU, spend fewer days as inpatients and are more likely to return home rather than to a nursing facility.

Interestingly, despite the potential for cost savings, Geisinger hasn't found insurers willing to take the deal just yet, other than its own captive insurance unit serving 210,000 Pennsylvanians. (Perhaps the package deal isn't priced aggressively enough.) Insurance execs have told Geisinger that the program won't appeal to them unless it adds a total of five to 10 high-ticket procedures to the package program. Otherwise, the package deals don't affect enough beneficiaries to make the program worth their while, health plans say.

To find out more about this initiative:
- read this New York Times article (reg. req.)

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Tenn. hospitals put prices online

Mon, 23 Apr 2007 20:01:37 -0400

Bowing to the pressures created by the consumer-driven healthcare trend, the Tennessee Hospital Association has created a website offering service prices for most of its 136 member hospitals. The site, which draws on data reported to the state from October 2003 to September 2004, list average prices for common procedures. HCA hospitals aren't included in the tally, but the site does link to HCA's own price disclosure sites. (HCA recently decided to disclose prices for common procedures at all of its hospitals.) The THA is following the lead not only of hospitals, but of sites run by insurers such as BlueCross BlueShield of Tennessee, which have also begun posting price information on the Web. The THA website doesn't address hospital quality ratings, but it does link to HHS's quality rating site Hospital Compare.

To get more background on the hospitals' plans:
- read this piece from The Tennessean

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TX site offers hospital price comparisons

Tue, 27 Mar 2007 20:01:36 -0400

The Texas Hospital Association (THA) has become the latest industry group to promote price transparency and allow for comparison shopping, joining Wisconsin, New Mexico, Oregon, Washington, New Hampshire and several other states with similar initiatives in place. To accomplish this objective, the THA has launched a new site, Texas PricePoint, which pulls together charge data on the most common inpatient services provided by Texas hospitals. The new site also offers links to data and broad information on the state's hospitals.Texas PricePoint not only offers the data by individual hospital, but also offers tools which allow users to compare multiple hospital prices side by side. The data used by THA is supplied by the hospitals, and will be updated quarterly.

To get up to speed on the THA initiative:
- read the group's press release
- read the Austin Business Journal piece

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PA bill requires healthcare pricing disclosure

Wed, 21 Mar 2007 20:01:35 -0400

A group of new bills currently progressing in the Pennsylvania state legislature could change the way the state's consumers shop for healthcare. The bills, which are part of an overall health reform push by Gov. Ed Rendell (D), include a measure requiring the state's pharmacies to submit their retail prices on the 150 most popular drugs to the Pennsylvania Health Care Cost Containment Council. This measure would also call for the state to launch a hospital payment registry, which would detail payments hospitals received for the 150 most frequent admitting diagnoses and most-frequently dispensed drugs. The prices would need to include the amount uninsured patients pay, the amount patients with high-deductible plans pay, and the average payment accepted from standard health plans.

For more about the proposals:
- read this Pittsburgh Post-Gazette article

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Report card on CA doctors coming

Mon, 12 Mar 2007 20:01:37 -0400

A large California health purchasing group is joining hands with some of the state's large health plans and Medicare to produce report cards on individual physician performance. The effort, which is led by the Pacific Business Group on Health (PBGH), will draw data from Medicare, Blue Cross Blue Shield of California and PacifiCare/UnitedHealth to create the report cards. The effort is part of a six-site pilot tracking physician performance across the U.S. The report cards will be presented to doctors by mid-year, to give them a chance to get up to speed. Eventually, the PBGH plans to release the report card data to the public. Once released, the report cards could have a meaningful impact on health decisions in the state, given that the PBGH represents employers who spend $10 billion per year on healthcare.

To learn more about the planned report card:
- read this Sacramento Business Journal article

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HCA posts hospital prices online

Tue, 06 Mar 2007 19:01:38 -0500

HCA has decided to roll with the transparency trend. Over the next few months the hospital chain will begin making prices for its services publicly available, starting with hospitals in Dallas, San Antonio and Austin, Texas. HCA expects to start disclosing prices in Tennessee over the next few months, and should roll out the program to all of its 165 U.S. hospitals by this summer. Prospective patients will be able to check out prices for common procedures by following a link on the hospital's website. The sites will also give insured patients instructions on how to get a price estimate. (Given how much managed care contracts differ, the hospitals won't be able to offer a pre-packaged answer on what an insured's care will cost.) While HCA seems to be ahead of the curve in posting prices across its entire network, other hospitals are increasingly providing price quotes when asked, observers note.

To get up to date on HCA's plans:
- read this piece from The Tennessean

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