When it Comes to Health Care, We’ve Been Living in the Land of Oz for Too Long

Sep 6, 2013, 4:30 PM, Posted by Tara Oakman

Cost Report April 2013

“Pay no attention to the man behind the curtain! The Great and Powerful Oz has spoken!” 

In some ways, our health care system has traditionally functioned much like the fantastic land of Oz depicted in one of my favorite movies.  Consumers and purchasers are expected to be passive consumers, doing what they are told and paying whatever price is levied based on a high degree of trust and limited information. This model seems increasingly ridiculous. We now face an urgent need to improve the quality and efficiency of our health care system.

But to do that, we need information, a lot of information. Health professionals, purchasers, consumers—basically anyone who comes in contact with health care—need timely, accurate, comprehensive information on cost and quality if they are to make smart decisions. Without such information, not even a wizard could do the trick. But right now, such information is usually unavailable, or, when it is accessible, too often indecipherable. In fact, the Institute of Medicine estimates that $105 billion is wasted every year in the U.S. because of a lack of competition and excessive price variations in health care, and a lack of information on the price of health care services plays a large role in this waste.

This critical need for information is why RWJF is submitting a letter today to the Centers for Medicare and Medicaid Services (CMS), in response to their request for input on the potential release of Medicare physician payment data.

At RWJF, we have long supported public reporting and data transparency: It helps consumers make informed decisions about their care, helps providers identify areas for quality improvement, and gives purchasers the tools they need to optimize value. More and more states, regional collaboratives, hospitals, providers and health plans are part of public reporting programs.

In most cases, however, the data are incomplete because they do not include all public and private payers, limiting the impact that these transparency efforts can have toward getting more value for our health care dollars. Because Medicare is the largest payer of health care services in this country, the release of Medicare payment data will significantly expand the comprehensiveness and reliability of available data, thereby expanding the current benefits of measurement and reporting.

So, to truly transform our health care system, it's time we find the courage, heart, and wisdom to pull down the curtain and pay attention.