Thursday, May 23, 2024

Healthcare Prices, Quality Information Remain Elusive In Most States

The move to require healthcare prices to be made public and inform patients about quality is going virtually nowhere in most U.S. states, a new report shows.

This leaves most consumers lacking the “information they need to make informed healthcare choices” when such price and quality of care data isn’t provided, Altarum and Catalyst for Payment Reform say in their new analysis.

“We continue to find that most states miss the mark in providing consumers with usable price and quality information,” Altarum ’s Center for Value in Healthcare director François de Brantes said.

Only Maine scored above a letter grade of “F” in “both price and quality information,” de Brantes said. “That means that in 49 out of 50 states, consumers are basically in the dark when it comes to making value-based healthcare decisions .”

To be sure, the move to value-based care is escalating and states aren’t keeping up. Increasingly, employers and health insurance companies are no longer paying doctors and hospitals based on the volume of care delivered in a fee-for-service system.

Instead, they are moving providers to value-based models that base reimbursement on the quality of care delivered. Large insurers including Aetna, Anthem, Cigna and UnitedHealth Group report more than half of their payments are now made via value-based models.

States earning a passing grade on price transparency did so because they have “robust laws promoting and mandating price transparency that offer consumer-friendly, free websites with meaningful price information,” Altarum and Catalyst executives said. Those states are Maine and New Hampshire, which each earned an “A” while Maryland and Oregon each received a grade of “B.” Colorado, Vermont and Virginia received price transparency scores of C.

When it comes to quality, Altarum and Catalyst graded states in part on whether they had free websites for consumers containing quality measures that provided meaningful information. Only California and Minnesota earned an “A” letter grade.

States should be providing information on whether doctors are doing what “guidelines say they should” as well as what kind of outcomes physicians provide and the kinds of experiences their patients are having, authors of the report said.

“The whole point of this report is to determine whether states are ensuring that all citizens have access to information to help them make good healthcare choices,” Suzanne Delbanco, executive director of Catalyst for Payment Reform said in an interview. “States can really play an important role but very few have stepped up to do that.”

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