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HOUSE_OVERSIGHT_020996

House Oversight Committee
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Restructure Medicare & Medicaid: Economic Factors—Possible Solutions

3) Improving Cost & Quality Transparency

¢ Improving cost and quality transparency of healthcare services could help doctors and patients make more informed decisions for each situation.

° Though enhancing competition and price transparency in healthcare is not easy,' new models for encouraging “comparison shopping” are emerging: - Castlight Health, a start-up financed by venture capitalists and the Cleveland Clinic, is working to build a search engine for healthcare prices? - Other services beginning to publish price information: Thomson Reuters, Change: healthcare, and health insurers (e.g., the Aetna Navigator)?

* A 2007 study by Deloitte proposes a “Price Transparency Checklist for States”:

provide prices for services that matter to consumers

make it easy to understand

keep care providers, insurance & pharmaceutical companies engaged and informed provide price and quality measures

keep expanding price transparency initiatives

maintain methodological rigor

promote access and use of price information

evaluate impact and ROI

Source: 1) The Market for Medical Care: Why You Don’t Know the Price; Why You Don’t Know about Quality; And What Can Be Done About It, by Devon M.

Herrick and John C. Goodman, March 12, 2007; 2) “Bringing Comparison Shopping to the Doctor's Office,” The New York Times, June 10, 2010; 3) Healthcare

KP Price Transparency: A Strategic Perspective for State Government Leaders, by Deloitte Center for Health Solutions, 2007 www.kpcb.com

USA Inc. | What Might a Turnaround Expert Consider? 309

Restructure Medicare & Medicaid: Economic Factors—Possible Solutions

4) Deploy Cost-Benefit Analysis for Medical Technology Spending

e Deploying cost-benefit analysis for medical technology spending can help ensure we are spending resources wisely.

e Directly measuring the impact of new technology on total healthcare spending — and its true value — is very difficult'

e The Kaiser Foundation outlines some of the more common policy suggestions for dealing with this driver of costs: — Cost-effectiveness analysis (i.e., comparative effectiveness)

— Rationing (unlikely to be adopted owing to political sensitivity), regulation, budget-driven constraints (used by other countries but generally not popular in the U.S.)

— Market-based rationing (consumer-driven healthcare, pay-for- performance, information technology)

Source: 1) “How Changes in Medical Technology Affect Healthcare Costs,” Kaiser Family Foundation, March 2007. (@E) www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 310

HOUSE_OVERSIGHT_020996