Price And Quality Transparency Report Card

Newtown, CT - November 10, 2017

I saw a movie once in which one of the main characters stops another in mid-sentence and says: “My dad taught me long ago that anything before “but” is an excuse, so just get to the point.” That’s an important lesson when listening to those who claim they’re all for transparency, but….—As we released our 5th annual report card on price transparency and physician quality with our friends at CPR, there have been a lot of statements that started with emphatic claims supporting, and praise for, price and quality transparency, soon followed by the inevitable “but.” Of course, most states have to backpedal when faced with double Fs and explain to their residents why they feel it’s ok to leave everyone in complete darkness on close to one fifth of their economy. They have little recourse other than “but.” That’s why, for the first time, we published a special addendum on a double F state, Connecticut, to illustrate what happens when no one can find reliable information on the price and quality of health care. The upshot is that the next time you hear anyone emphatically support price transparency and follow-up with “but,” you need to shut them down with a clear-cut: There is no “but,” and here’s why.

What this means to you – The Connecticut addendum is a quick read, but worth summarizing for the purpose of this missive. As context, it’s important to understand that the Nutmeg State has had an All-Payer Claims Database (APCD) legislatively mandated for several years. However, and for a variety of reasons – most of which aren’t that good – there has yet to be any public disclosure of price or quality of providers. And yet, no other state in New England would likely benefit more from transparency than Connecticut. Its premiums are the highest (or very close) of any other NE state, including Massachusetts, and out-of-pocket expenses have been rising at a steady 9% per year – enough to choke off most average families. In addition, Connecticut has the dubious distinction of having the highest number of low Leapfrog-graded and Medicare-starred hospitals in New England. Now, to be clear, we’re not exactly fans of the Hospital Compare grading system, but it has the merit of being uniformly applied to all hospitals and, as such, it makes it a little difficult to explain away consistently worse scores in Connecticut than neighboring states. The bottom line is simple: the majority of hospitals and health systems in my state offer very little value to the populations they serve. And as some of you who follow this weekly message know, there’s a nasty little fight in the state between Anthem and Hartford Healthcare. Well this addendum, beyond showing what happens in the absence of transparency – prices go up and quality doesn’t get better – also makes a strong case for why hospitals and health systems in Connecticut need to start providing far better value before having the audacity to ask for more money. And just remember, when they or anyone else start with bold claims and statements about how they agree and support this or that and lead into “but,” that everything preceding that three letter word is just a pile of a four letter word. Transparency matters. And there are no buts.