Hospital transparency an illusive ideal

Implications: Patients requiring health care today demand quality.  Quality from their physician, their diagnostic services, and the insurance companies.CMS already mandates certain levels of quality and hospitals.  They assure these quality levels by doing spot inspections, and also contracting with the joint commission, which mandates certain levels of care in order to get paid by CMS. Most patients desire to trust the physicians and hospitals that they choose for their care.  Many patients when asked will say that they do not know the reason they are having a certain test or procedure only that the physician has requested it be performed.  Often they simply want to trust the physician to care for them in the appropriate manner. people requiring health care would like to have transparency in pricing. It would be great for patients to understand the cost of their health care, and the actual reimbursement.

Analysis: The article states that transparency and healthcare will increase the level of quality provided. It states that Medicare should take a more active role in requiring transparency.  CMS website already has information on most hospitals patient outcomes and performance measures. Most hospitals today, must be accredited by CMS, the joint commission, or other qualified accrediting body in order to be reimbursed. these agencies have specific goals that must be met by the facilities.  As in most manufacturing industries, quality assurance personnel are charged with verifying the quality of any facility that provides health care and is reimbursed by CMS. What more transparency?

Most health care facilities desire to provide the highest level of care possible. Most patients expect their physicians and health care  providers to be competent, compassionate, and empathetic. Health care facilities; hospitals and diagnostic centers, only provide treatment and is ordered by physicians.  This treatment is overseen by quality assurance personnel and guided by CMS and other accrediting bodies.

What should be more transparent? Physicians dictate the care delivered. Do you have the best physician taking care of your specific problem? Is this physician ordering the appropriate tests? Is this with position willing to refer you to a specialist? how long will this position keep you in the hospital before consulting with a specialist or other physician?  These are difficult questions to find the answers. Transparency may include grading specific physicians on core measures of competency nd making these public information.

Transparency in insurance reimbursement would be beneficial. Most people do not understand that the reimbursement compared to the actual charge amount varies with each payer.  Most would be very surprised to find out that health care providers routinely receive less than 50% of the charged amount.  Also surprising would be the actual cost to a healthcare facility for providing that  care. Transparency may also show the public.  The amount of quality care provided to those indigent payers.

In the end, the best way to assure you are receiving quality care is to ask questions,  perform research, and be yet active member of your health care delivery team. This is the reason that patient advocates and healthcare coaches are becoming more prominent.  Health care providers are less profitable and less willing to spend the time necessary to completely inform, therefore you must take an active role and insist on finding answers.