Last week, the Office of Consumer Affairs and Business Regulation held its second community conversation conference on “empowering healthcare consumers.” Click here to read more about the conference and the featured speakers and to see information about the first conference held last spring in Boston.
The bulk of the gathering involved a panel discussion on healthcare price and information transparency and, later, facilitated table discussions on health care choices. Panelists included representatives from insurance carriers (Harvard Pilgrim, Fallon), purchasers (GIC), health care providers (Steward, Reliant Medical Group, MHA), government (Office of Consumer Affairs and Business Regulations) and an employer group (Associated Industries of Massachusetts).
The panel, moderated by reporter and anchor Susan Wornick, discussed cost transparency tools and what needs to happen for consumers to utilize the information in a meaningful way. A few panelists mentioned the apparently often-held belief among consumers that if something is more expensive it must be better, including in health care, and that websites should be set up in a way to allow for that myth to be busted. This can only happen if websites present cost and quality information side-by-side in an easy to navigate and understand format. One panelist made the interesting point that there is no quality measure for when something (a procedure, test, etc.) is not done, though this should often be one of the options discussed by the patient and provider, and that discussion in actuality does not happen often enough (as more provider use shared decision-making tools, hopefully those discussions will happen more often). Another panelist pointed out that cost and quality information is useful not just for consumers but for referring doctors, who would like to have that information easily available when they are making referrals. Panelists also commented on the difficulty of asking the consumer to take on the role of making decisions when they are sick and/or vulnerable, which is why this needs to be a partnership conversation involving the provider and the patient/family.
The table discussions involved a scenario in which you are undergoing physical therapy for a rotator cuff injury and during that time you are researching your options among 5 different hospitals in case you have to have surgery. Nicely laid out on a sheet of paper (unlike what can be found on-line) was an easy-to-understand chart showing things like rate of infections/complications, length of stay, number of surgeries per year, patient satisfaction, total cost and total out-of-pocket cost. Even when out-of-pocket costs were the same at all 5, nobody chose the hospital that had the highest overall cost because they saw that length of stay and the patient satisfaction and infection/complication rates were worse than at some others. So at least for these well-informed consumers, when given clear information on quality, they are able to make a choice based on something other than the alleged myth that more expensive is better. However, for the general population this is much less true. Even with this information in front of us, we wanted more details so that we knew what it meant that one hospital had, for example, a low and another a medium complication rate.
We look forward to seeing how this statewide empowerment campaign, to quote Barbara Anthony, will evolve. These first two conferences were a great opportunity to explore the issues but most of the folks in the audience were not there purely in their role as consumers. We hope the next steps will reach more of the general public, and we are happy to be one of a number of partners in this effort.