I’m a big fan of historical fiction, and just finished up “Madame Tussaud: A Novel of the French Revolution”by Michelle Moran. I’ve read many fictional and non-fictional accounts of that time period, but the depiction of the French citizenry’s dissatisfaction with the monarchy and just about everything else in their society struck a particular chord with me this time around. I don’t think I go too far in saying there is just a hint of their discontent brewing in the world healthcare consumers. While consumers and patients haven’t quite reached the level of hysteria the likes of Robespierre or Marat did centuries ago, there now seems to be a societal voice given to a need – I’d go so far as to say a right – to know the true costs of medical services before and after they are supplied.
And I wonder if the government’s push towards electronic medical records and more coordinated care isn’t halfway to blame. Easily accessible information, such as patient health data and doctor’s notes that can now be placed directly in patients’ hands has made us all wonder, “If I can understand the reasoning behind my doctor’s directives, why can’t I understand the reasoning behind the cost of that care?”
I mentioned last week my discontent with the way I was approached by my hospital to pay for labor and delivery services shortly after my daughter’s birth. It was no surprise to me then to come across “American Way of Birth, Costliest in the World,” a well-written article in the New York Times chronicling a number of mothers’ similar frustrations with healthcare costs, billing and payment. In these days and times, I could not imagine trying to navigate the financial part of pregnancy, labor and delivery without insurance coverage. And it saddens me that for all the money that we spend in this area of healthcare, our infant and maternal mortality rates are nothing to be proud of.
But I digress. My true point this week is that there is a growing movement by consumers to demand transparency into healthcare costs – ideally before treatment is given, but most definitely after it is received. Providers should be able to explain services line item by line item, and consumers should be able to compare the costs of those services provider by provider, hospital by hospital. I’m confident we’ll get there, as this movement only seems to be growing. There’s an interesting timeline that has occurred:
March 4 – Time Magazine publishes Steven Brill’s oft-referenced article “Bitter Pill: Why Medical Bills are Killing Us,” perhaps kicking off CMS’ attempts to bring greater transparency to healthcare costs
May 7 – CMS releases new open dataset to shed light on hospital pricing variations
May 8 – Mainstream press, such as The Washington Post, publish lengthy online articles complete with data visualizations to assist consumers in understanding the vast differences between what hospitals charge Medicare for their services.
May 15 – CMS releases state and national averages a week after The Washington Post article, aggregating the data for comparison on the state level.
June 3 – CMS releases another wave of data, including average estimated submitted charges for 30 types of hospital outpatient procedures; information on Medicare spending and utilization at the county, state and hospital-referral region; and the prevalence of certain chronic conditions among Medicare beneficiaries.
July 5 – The Center for Studying Health System Change releases study on “Geographic Variations in the Cost of Treating Condition-Specific Episodes of Care among Medicare Patients” showing that geographic variations in Medicare medical treatment costs can differ among episodes of care for certain conditions and not only across but within regions.
How will all this play out in the coming years? Will consumers continue and increasingly demand to know what healthcare will cost them? Will private payers offer up this same type of information sooner rather than later? Should this knowledge be a right, rather than a privilege? What do you think? Let me know via the comments section below.