Health Policy Issue Brief: Recommendations to Achieve a More Transparent Health Care System for Consumers

As solutions to address excessive health care costs continue to attract debate, policymakers and researchers believe that increasing health care data transparency – the process of providing the public and other critical stakeholders with information on health care prices and quality of care – is key to achieving overall health system improvement. Unlike any other market, consumers of health care do not have ready and user-friendly access to cost and quality information, which means they cannot compare the price or quality for a particular service (knee replacement, diagnostic test, etc.) before they purchase it.

Especially in the current health care environment, where consumers are taking on more of the cost burden through increasing out-of-pocket costs, particularly from the growth of high deductible health plans, they need and want more information.On the provider end, there is also an increasing need for transparency. Just like consumers, physicians have limited price and quality information either on the drugs and devices they prescribe or on other providers, meaning that they too operate with a lack of transparency. However, new models of paying for and delivering care emerging out of the Affordable Care Act – such as bundled payments, patient centered medical homes, and accountable care organizations (ACOs), which all render providers financially accountable for the cost and quality of their patients’ care – make it important for physicians to be choosier about which providers they partner with and refer their patients to.

This brief was prepared by gathering insights from over twenty expert interviews with key payers, providers, researchers and consumer advocates. It also includes learnings from a recent Brookings event, Enhancing Health System Transparency through Meaningful Health Data Releases. The aim is to move beyond recommendations designed to merely increase the volume of data available to the public, and propose concrete next steps for rendering transparency meaningful to those who are expected to use it to make better health care decisions, namely, consumers. We split those recommendations into (1) regulatory issues that need to be addressed to facilitate meaningful data transparency, and (2) which data should be provided, and how, in order to ensure its effective use by consumers.