“Public Reporting Works…”
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A few days ago, Doug Brown wrote an opinion piece in the Boston Globe about UMass Memorial Health Care’s experience with public reporting of cardiac surgery outcomes. The article speaks for itself, but the short story is this - when Massachusetts expanded the number of hospitals who could do cardiac surgery in 2000, the state established a public reporting mechanism, so that the state would be able to determine if the expansion had affected the quality of cardiac care. UMass’s risk adjusted mortality when the results were first released was twice the statewide average. They did the right thing - suspended the program - figured out what was wrong, re-structured it, and did quite well in recent rankings.
The first conclusion Doug drew from the turnaround was that “public reporting works.” No kidding. If we are ever going to get serious about the cost/quality problem in health care, it will start with public reporting. The bright hot light of outlier performance - on either measure - is a far more powerful tool for reform than any other mechanism we can collectively bring to bear.
I hope I live long enough to see it happen.
And to think Charlie that Pennsylvania started doing this type of thing back in the 80’s. You have to wonder just what is taking so long in the most costly state, and the only state with mandatory coverage. I’m no health care expert, but it seems to me to be simple common sense that positive outcomes are ultimately far cheaper to the system than negative outcomes. To require insurance coverage without making this information widely available is putting the cart before the horse. And to not deliver on the promise of transparency by this point should be of great concern to all consumers in the state.
Jon — Totally agree. The Health Care Quality and Cost Council - of which I am a member - is planning to put its first cost and quality data up on its web site in November. Can’t happen soon enough.