Transparency & Value-Driven Health Care

Partnership for Value Driven Health Care

AHA and the Chamber have signed on in support of the Partnership for Prevention's "Leading by Example" initiative and will be encouraging our members to participate in this proven program to lower costs and improve the health of their workforce.  The initiative is designed to leverage the workplace to improve health by promoting greater business involvement in health promotion and disease prevention.  At the core of the initiative are enlightened CEOs who play a pivotal role in advancing worksite health promotion both through their influence on corporate culture and visible support for such programs.  These CEOs "lead by example" in that they make health promotion and disease prevention a part of their business strategy to achieve success through optimum employee performance and management of health care costs.  Profiles of successful "Leading by Example" initiatives are described at http://www.prevent.org/.

To access the New Value -Driven Health Care Purchaser's Guide, click below:
http://www.leapfroggroup.org/news/leapfrog_news/Purchaser_Guide

What is Transparency and why is it Important?

With the early success of Health Savings Accounts and the increasing popularity of Consumer Driven Health Care products which place both the decision making ability and healthcare dollars in the hands of the consumer, greater emphasis is being placed on the availability of information surrounding health care services. In order to best use the consumer driven health care products and to make wise, informed decisions about the various health care services available, individuals must have greater access to information on cost and quality.

Consumers must be able to evaluate and compare the cost and quality of health care services.  How much is a specific surgery at one hospital, as compared with another?  Which hospital has better outcomes from, performs the greatest number of, and has the lowest readmission rates following a specific surgery?  Additionally, what are the success rates of alternative surgeries/procedures?

Individuals need to have access to this data in order to make the best decisions about where and how to spend their health care dollars.  If one surgery or facility is more expensive than another, are the quality differences important and do they potentially offset the price variances?

What the Administration is doing to increase Transparency

When President Bush signed Executive Order 13410 on August 22, 2006, committing Federal health programs to provide meaningful, consistent information on both the quality and price of health care services, he introduced the Four Cornerstones of Value-Driven Health Care.  These four goals strive to: 

• Support Health Information Technology,
• Provide Quality Information,
• Provide Pricing Information, and
• Promote Quality and Efficiency of Care. 

By committing to support implementation of these objectives, employers and other purchasers are indicating their intent to make a good faith effort to use their purchasing power to advance interoperable health IT, quality and cost or price transparency, and incentive for providers and consumers, such as pay-for-performance and consumer-directed health plans, as set forth in the Executive Order.  The extent to which an employer obligates its contracted health insurance plans to implement these goals is a matter for each employer to determine.  If your company would like to sign on in support of this important initiative, please submit your statement online at http://transparency.cit.nih.gov/#sign-up.  Alternatively, you can complete this Statement of Support and send it to HHS via mail.

If you have any questions about Value-driven Health Care, answers to frequently asked questions are available here: FAQs.

Read a letter from HHS Secretary, Michael Leavitt, inviting CEOs to play a leadership role in the movement toward transparency and value-driven health care purchasing.  You can view this letter in PDF form here: Letter to CEOs.

The use of a common set of RFI/RFP (request for information/proposal) questions can help promote value-driven health care by assessing the degree to which health plans operate in a manner consistent with the principles of value-driven health care outlined in the Executive Order 13410. The following sample may be used as a guide by purchasers to inform their discussion with plans: Sample Request for Information: Version 1.0

The Chamber's Focus on Transparency

In order to facilitate and support consumer driven health care products and other alternatives to traditional insurance products, the Chamber continues to advocate for greater transparency in both quality and price information.

The Chamber has joined other sponsors of the Hospital Quality Alliance (HQA), including the American Hospital Association, Federation of American Hospitals and the Association of American Medical Colleges, to work in partnership with the Centers for Medicare and Medicaid Services (CMS), on the Hospital Compare website, http://www.hospitalcompare.hhs.gov/. Participating hospitals voluntarily report quality information on 20 clinical measures for public use (for reporting this information the hospitals also receive greater Medicare reimbursement rates). This website provides information on how well the hospitals care for their adult patients with certain medical conditions; the website provides a tool for consumers to compare the quality of care that these hospitals provide.

The issue of transparency involves more than just the publication and dissemination of price and quality data; transparency overlaps with many other issues. 

In order for quality transparency data to exist, there must first be a common, uniform, accepted method for assessing and evaluating quality.  Incentives must also be realigned to reward quality and a cultural shift toward reporting quality and outcomes needs to occur; private payers can do little on their own. For these reasons, coordination among the concepts of quality improvement and reporting, the establishment and dissemination of evidence based medicine protocols, widespread adoption and use of health information technology, and pay for performance is paramount.