I couldn't help but think I viewed a "tipping point" when reading the excellent journalistic piece reported by the Boston Globe last week, entitled, "A Heathcare System Badly Out of Balance" that describes the complicated pricing differentials between large "name brand" hospitals and their competitors in the Boston healthcare market.
But what made the writing of this piece possible was one small event. A tiny disruptor. What was that tipping point?
It was the ability to compare costs that permitted the revealing report:
The insurance data obtained by the Globe, drawn from millions of medical claims collected by the state Health Care Quality and Cost Council, is a byproduct of the state's sweeping healthcare reform law of 2006. Because some hospitals treat sicker people, the data has been adjusted to reflect the cost of care for an average patient.But transparency, as the authors point out, was not easy to come by and verify.
The law calls for the council to post insurance claim information on the web so that the public can see the disparities.
But a year and a half after the law was passed, the council has still not published its findings because of disputes with medical groups about how the numbers should be presented and whether they are accurate in every detail.It is important to realize that price transparency did not always change peoples' perceptions or actions (particularly if they did not have to pay for services through insurers). But for others with high-deductible insurance policies who bore much of the cost for tests themselves, price mattered.
"Apparently, this subject is the equivalent of the third rail," said Gregory W. Sullivan, the state's inspector general and a member of the Quality and Cost Council.
However, council officials say privately that the data, after months of review by the hospitals, is generally accurate. Partners said it has raised concerns "about the data and methodology" with the council. But other hospitals contacted by the Globe either confirmed the data's accuracy or would not comment on it.
In the days ahead as policy makers meet to hash out details of our new health care strategy for the future during these harsh economic times, insisting on verifiable price transparency from all parties will serve as a powerful incentive to improve quality while reining in costs to the ultimate health care consumer: the patient.