The Network for Excellence in Health Innovation (NEHI) www.nehi.net report “Transparency in Health Care: A Priority Roadmap for Consumer Engagement” found current trends in health insurance, growth of narrow provider networks, restrictions on coverage for prescription drugs, and information gaps which can result in higher costs for consumers.
According to Susan Dentzer, President and CEO of NEHI, “All stakeholders in the healthcare system should push for more transparency in healthcare costs, quality, and outcomes, and at the same time, provide for better consumer education on the consequences of their healthcare choices.”
The report points out that consumers generally don’t understand that they may face multiple treatment options for a given condition that may or may not match their own preferences. They are also typically unaware that healthcare costs can vary widely for the same service often with little or no correlation to quality.
To address these issues, NEHI’s report calls for a broad public awareness campaign on healthcare choices and consequences. The report also recommends steps to spur shared decision-making between patients and providers. This includes extending some liability protections to physicians who engage their patients in a careful process of jointly considering various treatment options.
There are multiple tools to help guide consumers through their decision-making such as choosing a physician or a health plan, but these tools are not uniformly available or useful. Consumers are typically unaware that these tools exist, don’t use them, or find the tools difficult to understand.
NEHI’s report calls for simpler tools focused on consumer information priorities, better marketing of tools to consumers, and more availability of tools across all populations at key decision points.
The report also suggests that public and private tool developers should build on lessons learned from the tools that support consumer choice among plans on ACA exchanges. Laws and regulations should also support the development of tools to allow consumers to determine their specific cost-sharing responsibility based on negotiated payment rates between plans and providers.
NEHI’s report also recommends that policy-makers pass laws that hold plans and providers accountable for the accuracy of the data that they publish in provider directories and in other materials. This would protect consumers from the financial consequences from acting on bad data.
Go to www.nehi.net/writable/publication_files/file/nehi_transparency_report.pdf to view the NEHI report that includes the full list of nine recommendations. For more information on the report, email Caroline Steinberg csteinberg@nehi.net.