ACP: Improved Transparency Requires Reliable Data

The benefits of increased healthcare transparency hinge on reliable and valid information—specifically in the areas of price and clinical performance, according to a white paper released this week from the American College of Physicians (ACP).

"We believe that increasing transparency in the healthcare system can be beneficial to both patients and physicians," said J. Fred Ralston Jr., MD, president of ACP. "However, unless the transparency information that is collected meets certain criteria it will not accomplish the goal of improving health care."

ACP said that for the potential benefits of healthcare transparency to be realized, the reported information needs to be:

• Reliable and valid.
• Transparent in its development.
• Open to prior review and appeal by the physicians and other health care professionals referenced.
• Minimally burdensome to the reporting physician or other health care professional.
• Comprehensible and useful to its intended audience, including a clear statement of its limitations.

While the issue of transparency in price information delivered by providers for a healthcare service seems straightforward, "in actuality it is quite complex," the study said.

Besides being transparent, any methodology used to publicly report price needs to contain adequate protections to ensure the reporting of reliable and valid price information, ACP recommended. In addition, price information provided to patients or consumers should be readily available and "presented in a manner that is easily understood and reflective of its limitations."

 
Price also should never be used as the "sole criterion for choosing a physician or any other healthcare professional." Price should only be considered along with the “explicit consideration” of the quality of services delivered and/or the effectiveness of the intervention, ACP noted.

For increasing the use of clinical performance transparency, ACP called for looking at clinical quality, resource use, and experience of care, which is the patient's view of care received from a provider. 

Among its recommendations, ACP called for physicians and other healthcare professionals to have timely access to "assessed performance information prior to public reporting and the availability of a fair and accurate appeals process."

It also called for expansion of public reporting of physician performance differences that take into account technical capabilities to report "reliable, valid, and useful differences." ACP also said it supported the collection of both public and private data by trusted third-party entities so that physician and other clinician's performance "can be assessed as comprehensively as possible."

"Until they have access to accurate and useful information about what they are purchasing, both regarding price and clinical performance," Ralston said, "patients will not have the ability to make truly informed decisions regarding their healthcare."