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Benefits of increased health care transparency hinge on reliable and valid information, says ACP

(Washington) In a policy paper released today the American College of Physicians reaffirmed its support for increased health care transparency. Healthcare TransparencyFocus on Price and Clinical Performance Information, the first paper in a series of policy papers about transparency, is an introduction and overview of the issues and challenges faced with increased health care transparency.

"We believe that increasing transparency in the health care system can be beneficial to both patients and physicians," said J. Fred Raslton, Jr., MD, FACP, president of ACP. "However, unless the transparency information that is collected meets certain criteria it will not accomplish the goal of improving health care."

The college believes that for the potential benefits of health care transparency to be realized the reported information must be:

  • reliable and valid;
  • transparent in its development;
  • open to prior review and appeal by the physicians and other health care professionals referenced;
  • minimally burdensome to the reporting physician or other health care professional; and,
  • comprehensible and useful to its intended audience, including a clear statement of its limitations.

The policy paper lays out 13 new recommendations for how these goals for health care transparency can be met. The recommendations are broken into two different areas of transparency information: price transparency and clinical performance transparency.

In increasing the use of price transparency, the College believes that the following recommendations are essential:

  • ACP supports the goal of price transparency for services and products provided by all health care stakeholders to patients/consumers.
  • Any methodology used to publicly report price is also transparent, and contains adequate protections to ensure the reporting of reliable and valid price information.
  • Price information provided to patients/consumers should be readily available, presented in a manner that is easily understood and reflective of its limitations.
  • Any formal governmental or private sector requirements for price transparency minimize the administrative burden on the participating physicians or other healthcare professionals.
  • Price should never be used as the sole criterion for choosing a physician or any other healthcare professional. Price should only be considered along with the explicit consideration of the quality of services delivered and/or the effectiveness of the intervention.

In increasing the use of clinical performance transparency, the College advocates that the following recommendations:

  • ACP supports the goal of performance transparency for services and products provided by all healthcare stakeholders to patients/consumers.
  • The College also reaffirms and expands upon the qualities of a good performance measure as reported in the ACP policy paper, "Linking Physician Payment to Quality Care."
  • The College highlights the importance of "process transparency" in the public reporting of healthcare performance informationthe explicit delineation of the methodology and evidence base used to develop the measures being reported.
  • The College reaffirms the importance of physicians and other healthcare professionals having timely access to assessed performance information prior to public reporting and the availability of a fair and accurate appeals process to examine potential inaccuracies as reflected in the ACP policy paper "Developing a Fair Process through which Physicians Participating in Performance Measurement Programs can Request a Reconsideration of Their Rating."
  • The College reaffirms the "ACP Policy Statement Pertaining to Health Plan Programs to Rate Physicians" and recommends that the expansion of public reporting of physician performance differences takes into account the technical capability to report reliable, valid and useful differences.
  • The College supports the use of standardized performance measures and data collection methodology, consensually agreed upon by relevant nationally recognized healthcare stakeholders, in efforts to publicly report the performance of physician and other healthcare professionals. In addition, the College supports the collection of both public and private data by trusted third party entities so that physician and other clinician's performance can be assessed as comprehensively as possible.
  • The College, while recognizing and supporting the increased patient/consumer interest in obtaining and providing physician performance information, does not support the use of web-based physician rating sites that rely on subjective and invalidated data, and do not meet the College's standards for physician performance measurement.
  • The College supports increased efforts to determine and employ the most effective means of presenting performance information to patients/consumers, and to educate these information users on the meaning of performance differences among physicians, hospitals and other providers and on how to effectively use this information to make informed healthcare choices.

"Until they have access to accurate and useful information about what they are purchasing, both regarding price and clinical performance, concluded Dr. Ralston, "patients will not have the ability to make truly informed decisions regarding their health care."


Contact: David Kinsman
American College of Physicians

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