Opening The ‘Black Box’ Of Health Care Data

Recent efforts by the Centers for Medicare and Medicaid (CMS) provide clinicians, health plans and consumers with ready access to health data that was never before possible. In fact, CMS released millions and millions of lines of data that reveal important information regarding physician payments, prescribing patterns and geographic distribution of health care costs.  But how helpful is this information to the everyday health care consumer?

A recent Engelberg Center for Health Care Reform event, Enhancing Health System Transparency through Meaningful Data Releases, discussed the value of health care data as it relates to transparency; a popular term that refers to the availability of free and open sources of information on health care costs, procedure prices, drug prices, etc. The goal is to offer consumers the opportunity to research and compare services in the health care marketplace, much like we can now in just about every other market. For example, there are few resources out there that offer the simplicity and user-friendly approach of a Consumer Reports tool, when attempting to find a high-value physician to perform a hip or knee replacement surgery. Of course, health care is a far more complex product, but the data sources simply do not exist in this easy-to-use format.

Ensuring that consumers have access to relevant health data is especially critical in the current insurance market, since consumers are now beginning to have more “skin in the game.” For a long time consumers overlooked health care cost information that was taken care of by a third party (i.e., their health insurance plan), but more and more employer-based plans and the new ‘Obamacare’ health exchanges are shifting these costs directly to enrollees...