The word “dysfunctional” often precedes three other words, “health-care system.” What critics have in mind are the soaring costs, exceeding those of peer countries, the inefficiencies and the relative lack of quality, many in medicine performing magnificent feats yet the system falling short along such basic measures as the rate of infant mortality. Part of the problem is a lack of transparency about price and outcomes, an opaqueness that makes accountability and improvement more difficult.
Susan Ackerman of the Center for Community Solutions and Willie Oglesby, an assistant professor of health and policy management at Kent State University, have put together a report, “Good Data Lead to Good Decisions,” that makes a persuasive case for Ohio moving more aggressively to enhance transparency in health care. Much is at a stake. Practically everyone feels squeezed by health costs. Achieve a degree of relief, and other priorities can be addressed, from public schools to individual paychecks.
As Ackerman and Oglesby remind, the Institute of Medicine estimates that one-third of health-care spending does not improve health. This wasteful spending stems from such factors as medical errors, wide variations in pricing, plus uncoordinated and unnecessary care. Bring to light better information about health care, and there is a basis for improved policymaking.
That has been apparent in other industries. The federal government already has begun to share more information. So has the state via the Office of Health Transformation. Ackerman and Oglesby rightly argue for Ohio doing more, joining other states that have taken the lead.
Maine created the first All Payer Claims Database, a collection of medical, pharmacy and dental claims, along with eligibility information from public and private payers. The data allow for seeing more clearly the sweep, shape and detail of health spending, roughly $160 billion a year in Ohio. The state also would do well, according to Ackerman and Oglesby, to promote and upgrade its Ohio Hospitals Compare website, adding more functionality and accessibility.
In addition, with Medicaid at one-fifth or more of all state spending, it makes sense to be more transparent about the most frequently used services, the most commonly prescribed drugs and the largest provider organizations. That invites better-informed assessments.
This pulling back the curtain should attract bipartisan support in the legislature. Ackerman and Oglesby note that the debate about public schools and higher education has been aided by the availability of much data on spending and performance. So it should be in health care, transparency serving as a tool for advancing quality and controlling excess costs.