Federal Health Care Transparency Initiatives Supported By Employers
Most employers support greater transparency in the health care sector and would like hospitals and other health care providers to move forward quickly in achieving transparency in health care pricing, quality, and efficiency of delivery, according to a survey conducted by the National Business Group on Health (NBGH) and Mercer Health & Benefits LLC.
Researchers questioned 120 large employers about their views on an executive order signed on August 22, 2006 by President George W. Bush mandating improved transparency for Medicare beneficiaries and participants in health plans administered or sponsored by government agencies, including the Department of Veterans Affairs, the Department of Defense, and Medicare. The order directs federal agencies to share with beneficiaries information on the pricing of medical procedures and the quality of services delivered by health care providers. In addition, the order calls for the adoption of improved health IT systems and the development of initiatives promoting quality and efficiency in health care.
On November 17, 2006, Department of Health and Human Services (HHS) Secretary Michael O. Leavitt called upon private employers to lend their voluntary support to the health care transparency goals outlined in the president's executive order. The Secretary asked employers who agree with the goals to sign a support statement that would be distributed by the HHS to employers and other health care stakeholders.
Announcing the launch of the transparency campaign at the National Summit for Employers in Washington, D.C., Leavitt said, "If we are going to get a handle on health care costs—and we must—we first need to know what our costs are and what we are getting for our money."
Leavitt added, "Our nation's private employers are the major source of health insurance for Americans, and they can help provide the information consumers need to achieve better value for their health care dollars."
Results of the survey showed that 61% of employers are aware of the HHS transparency initiative. Of those respondents, 31% reported signing the letter of support, while 22% indicated they will definitely or probably sign the statement. The 10% of respondents in this group who said they will probably not sign the letter of support cited concerns about whether the campaign's goals are a good fit for their organization and its employees, as well as fears that the marketplace, rather than employers, will drive these measures.
At the same time, however, two-fifths of respondents told researchers they currently participate in a collaborative initiative focused on improving health care quality and/or cost efficiency. In addition, 29% of surveyed employers reported that they currently make some provider quality or cost information available to health plan participants. Of those respondents, 47% said they believe the release of this information has resulted in improvements in health care quality or cost, 21% said they doubt there have been improvements, and 32% admitted they do not know whether the information has had an impact.
When asked to assess whether the tools that are currently available for measuring provider performance are sufficiently developed and ready for use, 44% of employers said they believe current capabilities are adequate and performance measurement should begin immediately, while 30% of respondents said they believe provider performance cannot yet be adequately measured.
When asked to identify potential sources of resistance to provider performance measurement efforts, 82% of respondents cited physicians; 77%, hospitals; and 36%, health care vendors. Other major barriers to measurement initiatives mentioned by respondents included insufficient measures (63%), insufficient data (61%), cost (40%), and insufficient efforts by both private and public payers (40%).
Results further showed that 50% of employers place a high or very high priority on the release of Medicare claims data for use in performance measurement, while 32% do not view the publication of the data as a priority.
Commenting on the HHS campaign, Helen Darling, president of the National Business Group on Health, said, "One of the most important things employers can do to drive change in health care is to join with other employers and the government to leverage our collective purchasing power to foster transparency."
Linda Havlin, partner with Mercer Health & Benefits, agreed. "Employers need to rally more forcefully behind Secretary Leavitt's challenge to urge the public posting of Medicare claims data and engage the provider community in advancing transparency," Havlin said.
