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Advocating for Transparency in Health Care

ASCA works with legislators for patient access to health care data

BY JEFF EVANS |  JULY 2018

Access to health care information has come under increased scrutiny in the US Congress, and momentum for better transparency is building. In February, a bipartisan group of senators requested information from health care stakeholders regarding cost of care and price transparency. Led by Senator Bill Cassidy, MD (R-LA), the group issued a letter to the health care community as the first step in an “effort to increase health care price and information transparency to empower patients, improve the quality of health care and lower health care costs.”

The bipartisan letter asked the health care community several questions including:

• What information is currently available to consumers on prices, out-ofpocket costs and quality?
• What information is not currently available, but should be made available to empower consumers, reduce costs, increase quality and improve the system?
• How do we advance greater awareness and usage of quality information paired with appropriate pricing information?
• What current regulatory barriers exist within the health care system that should be eliminated to make it less burdensome and more costefficient for stakeholders to provide high-quality care to patients?
• How can our health care system better utilize big data, including information from the Medicare, Medicaid and other public health programs, to drive better quality outcomes at lower costs?

ASCA believes that patients should have the ability to compare cost, quality and outcomes across the health care system. To this end, the association advocates to state and federal lawmakers in support of policies that promote patient access to health care cost and quality information. ASCA’s principle legislative priority, the ASC Quality and Access Act, requires the Centers for Medicare & Medicaid Services (CMS) to establish a tool for Medicare beneficiaries to compare ASCs and hospital outpatient departments (HOPD) side-by-side.

ASCA submitted formal comments to Senator Cassidy and his team, which includes Senators Chuck Grassley (R-IA), Todd Young (R-IN), Michael Bennet (D-CO), Tom Carper (D-NE) and Claire McCaskill (D-MO). In response to the question about information not currently available, ASCA stated:

“ASCA is particularly concerned about the inability for consumers to compare cost and quality across sites of service. Many procedures can be performed safely and effectively at more than one site of service (i.e., hospital outpatient departments [HOPD] and ASCs). Congress demonstrated the importance of comparing costs across these two sites of service by passing legislation in 2016 instructing the Secretary of Health and Human Services (HHS) to develop a cost-comparison website for Medicare patients, but the site is not yet available to consumers and it will not include a comparison of quality measures.

“In addition, it is difficult to compare quality between sites of service because there are no uniform quality measures for Medicare or privately insured consumers. The quality data that Medicare collects is different for each provider and facility type, even those that perform the same services."

ASCs deliver high-quality, convenient and cost-effective care to millions of patients every year. ASCs save Medicare more than $2 billion and commercial insurers tens of billions of dollars each year; and research shows fewer post-surgery adverse events in ASCs than in HOPDs.

As declared in its comments to Senator Cassidy, ASCA steadfastly advocates for increased price transparency and accessibility to health care data that would assist providers, payers and especially patients as they consider choices in health care. ASCA will continue to monitor this issue as it gets increasingly more attention on Capitol Hill and in the regulatory agencies.