Additional Info

Cost-Price Transparency

Background

As the public becomes more informed and engaged in healthcare decision-making, there will likely be greater demand for cost and price information.  A nationwide survey done by the polling firm, Zogby International, found that 84% of those surveyed agreed with the statement “hospitals, doctors, and health plans should publish their prices.”  [1] Private purchasers are increasingly demanding that the health plans they contract with provide “cost transparency” in information for their enrollees and use “efficiency” information to design high performance networks of healthcare professionals.  The Centers for Medicare and Medicaid Services (CMS) has started making available comparative price information for various procedures. 

At present, there are multiple groups and organizations working towards greater transparency of cost and price information.  There is little consistency or coordination of underlying definitions and principles related to transparency of cost and price information, and a good deal of controversy as to the meaningfulness of some types of cost and price information being sought.  While individual efforts are moving the conversation along, we are at a point where practical and theoretical framing of the issues would be of value. 

Scope

The goal of this project is to produce a background paper and issue brief that will serve as a resource for developing a:

  • Common language/definition of terms; and
  • Conceptual model for considering different types of cost/price reporting with strengths and weaknesses including
  • Who should report?
  • What should be reported
  • Need for combining cost and price with other information (e.g. quality)
  • Potential market/competitive implications
  • Potential sources of data

The NQF Process

This will not be a consensus project.  In producing the background paper and issue brief, NQF will seek input from various stakeholders, including the Consumer-Purchaser Disclosure Project, the Hospital Quality Alliance, AQA (formerly known as the Ambulatory Quality Alliance), and CMS in an effort to better understand differing perspectives.  The project will be guided by an Ad Hoc Committee.  NQF Member and public comments on the background paper must be received via the CostPriceComments@qualityforum.org email address by Friday, July 13, 2007, 6:00 pm, EDT. 

Funding

Support for this project has been provided largely by the Robert Wood Johnson Foundation with additional funds provided by the California Healthcare Foundation.

1. Council for Affordable Insurance.  Newsletter. May 1, 2006