Refrigerator Report Cards - Health Care Editorial

Dear Health Care Leader,

Most children know there are two types of report cards. There are good report cards—the ones that occupy prime real estate on the front of refrigerators—and then there are those “other” report cards—the kind kids like to keep buried at the bottom of their backpack with the hope their parents will forget to ask for it. This week Colorado received one of those “other” report cards.

As HealthBEAT Today reported on Wednesday, the Catalyst for Payment Reform and the Health Care Incentives Improvement Project gave Colorado a “C” grade on a state-by-state report card for health care price transparency. Yes, that’s a passing grade, but it doesn’t reflect Colorado’s true potential. Never mind that Colorado finished ahead of 45 other states, I think we can all agree we could, and should, do better.

Before we can improve the consumer experience, we have to understand the challenges Coloradans face trying to access health care price information. With that in mind, the Association tasked members of the CHA Board of Trustees with a homework assignment. Prior to the March meeting, board members were asked to become a “secret shopper” for the price of two health care services (magnetic resonance imaging of one shoulder and total knee replacement) provided by their hospital or health system and to repeat the process for one health care service provided by a non-hospital provider of the same service.

Let’s just say, the shopping experience left a lot to be desired. Board members encountered a wide range of
responses including “I can’t tell you until you tell me the ICD-9 code,” “It depends on your insurance,” and “I’m just
not able to give you that information.” Board members also found the prices varied depending on whom at the
hospital was spoken to by the secret shopper.

Although the path to achieving health care price transparency is not clear, we do know that patients can’t be
expected to know ICD-9 codes. We also know our reluctance to make pricing information available frustrates
consumers, many of whom have now purchased high deductible health plans. So that leaves the question, how can
we meet patient needs in an era of transparency? CHA intends to lead the effort to develop best practices and
protocols hospitals can use to increase transparency of consumer pricing. Additionally, some of our hospitals have
indicated they are creating “pricing departments” that are responsible for providing this information to
patients. This proactive approach is something most hospitals may want to consider.

A report card represents one assessment at a given point in time. It’s not always an accurate indicator of future
success. There are plenty of academic late bloomers. Colorado hospitals have an opportunity to lead in pricing
transparency and set the curve. I suspect that in the future, we’ll not only have a fridge-worthy report card, but
we’ll be the example other states look to for guidance.