UNDER THE HEALTH HOOD

With hospitals listing prices and the federal government, Maine Quality Forum and other organizations expanding data on performance, the sick and someday sick will soon be able to examine levels of care with more information than ever. The outcome will change medicine from a question of trust to “trust, but verify” – with an emphasis on the latter.

Currently, the curious can browse through the federal Department of Health and Human Services’ “Hospital Compare” web site, where they can ask how Maine hospital performance compares with within state and with other states. Or they can visit the Maine Health Management Coalition’s site with ratings for doctors and hospitals. Consumers are seeing just the beginning of a wave of health-care information, and while it sometimes can be confusing, it matters immensely to the reform of health care all along the political spectrum. The key will be to ensure the data are easily accessible and meaningful to consumers and reform advocates.

For instance, the American Medical Association last month said it would develop 140 standard measures of performance that will track how well doctors and hospitals treat heart attacks, diabetes and pneumonia, among others, to give consumers a guide in choosing a physician or hospital. Next month, Dirigo’s Quality Forum will convene providers to examine a chain of care for acute myocardial infarction, identifying the types of treatment as well as the challenges of time and geography. Both hold promise for improving care.

Dirigo, which recently was named one of the Top 50 Government Innovations for 2006 by the Ash Institute for Democratic Governance and Innovation at Harvard University’s John F. Kennedy School of Government, will be crucial in bringing together information for, first, physicians and hospitals and, later, for the public. This democratizing of care data will take time, but it is happening nationwide with Maine toward the front of the pack.

Improving quality is one way of reducing costs; another is to make prices more easily available. But individual listings or listings of one hospital compared with a statewide average aren’t enough. The prices for all hospitals with outcome data should be available on a single site with easy-to-use information. If nothing else, the lists would give the public a feel for the price they would pay if uninsured -it is great incentive for getting coverage.

Beyond all this, however, is getting to actual costs – the many factors that make up the price consumers pay for care. Or maybe they don’t make up the price; it’s hard to tell. If the public wants to know why health care is so expensive, these data, along with utilization rates, will give them some idea. Maine and the nation are a long way from pulling apart the various prices to find out why they are set as they are, but with health care accounting for a larger and larger share of the economy, revealing these numbers is necessary.

Consumers should be able to know about the quality of care they receive. Anyone who pays for care should want to get the best value. This information is slowly coming to Maine, thanks in part to Dirigo, and the public should welcome it.