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Patients Given Lacking Info for Making Healthcare Decisions

Patients don't have access to adequate price transparency or care quality info for making healthcare decisions.

patient making healthcare decisions

Source: Thinkstock

By Sara Heath

- Most states do not offer adequate information to assist patients in making healthcare decisions, according to a joint report from Altarum and Catalyst for Payment Reform (CPR).

The report includes data about state policies on patient-facing price transparency tools and quality care information. The two organizations issued the report jointly for the first time, highlighting the importance that patients have access to both price and care quality information.

“So often, price and quality are conflated in such a way that consumers, even those who question the correlation between price and quality, are led to believe incorrectly that higher health care prices are indicative of better quality care,” the organizations wrote in the report. “We hope to continue to advance the point that consumers don’t have to pay top dollar to get good quality.”

Altarum and CPR defined a quality price transparency source as being a rich data source, having meaningful price information, and including a full scope of procedures and services.

The two organizations defined an effective quality resource as being independent and impartial, being freely available, containing timely data, displaying data on many physicians, presenting meaningful quality measures, and being findable and understandable for consumers.

READ MORE: How to Integrate the Patient Voice into Healthcare Decision-Making

Despite the need for patients to have adequate quality and cost information for their care, the report found that very few states actually offered that information. Of all 50 states, only one received a passing grade for both quality and cost information transparency, according to Francois de Brantes, Altarum’s Vice President and Director of the Center for Value in Health Care.

“We continue to find that most states miss the mark in providing consumers with usable price and quality information,” de Brantes said in a statement. “Only one state—Maine—scored above an F in both price and quality information. That means that in 49 out of 50 states, consumers are basically in the dark when it comes to making value-based health care decisions. But it also means that providing good information to consumers is possible and all states can get there. They need to have the will to do it.”

Forty-three states received an F grade for having adequate price transparency, the report showed.

Maine and New Hampshire received A grades, Maryland and Oregon received B grades, while Colorado, Vermont, and Virginia received C grades.

Maryland experienced the largest year-over-year improvement, the report showed. In 2016, Maryland received an F rating for having adequate price transparency. Since then, the state has launched a new price and quality website, which improved its ranking.

READ MORE: How Do Provider Profiles Influence Patient Care Access Decisions?

Forty-two states received F ratings for healthcare quality transparency, according to the report, and no states improved from the year prior. This highlights a significant need for improvements in healthcare quality reporting and transparency for patient decision-making.

California and Minnesota received A grades, and Maine and Massachusetts received C grades.

These high-ranking states all have independent websites ranking healthcare quality for patients to access, the report explained. These websites display the quality information that is important to healthcare consumers in an easy-to-understand manner.

Healthcare organizations and states have significant room for improvement, according to CPR Executive Director Suzanne Delbanco.

“While some large employers and health plans have made progress in providing price and quality information to those they cover, many Americans need another source,” Delbanco explained. “For most states, there is nowhere to go but up. CPR and Altarum will continue to do our part to help states get there.”

READ MORE: What Providers Should Know to Improve Patient Access to Healthcare

For states receiving failing grades for price transparency, CPR and Altarum identified varying levels of improvements. For example, some states haven’t yet even pledged to improve price transparency, and must do so to make any improvements.

From there, states must look at where they are on the price transparency spectrum and determine the next step forward. This will allow states to reach optimal levels, like those earning A grades have realized.

For states receiving failing grades for quality information transparency, CPR and Altarum suggested checking off each of the criteria for adequate quality information. Healthcare quality resources need to be accessible for patients and contain enough data points about enough doctors to be useful. Additionally, these sources need to be impartial, freely available, and contain timely data.

As patients assume more financial responsibility for their healthcare, they will assume more power in deciding where to access care. Patients therefore need adequate access to both cost transparency tools and healthcare quality tools to make an informed decision based on the elements important to them as patients.

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