MEDICAL ECONOMICS
Is the “price” right? Texas debates publicly posting physician fees
BY AMY LYNN SORREL The price of a gallon of gasoline is no secret, prominently displayed on stations’ signs, often across the street from a competitor. The same goes for milk or bread, whose prices are out there for all to see. If consumers are un- happy with one offer, they can shop for another and wind up with the same product for less. So why can’t shopping for health care work the same way? For one thing, the cost of medical services is not nearly as simple or predictable, says Su- san M. Strate, MD, a patholo- gist in Wichita Falls and past chair of the Texas Medical As- sociation Council on Socioeco- nomics. “Purchasing health care is
• Implementing innovative payment and delivery systems; and
• Enhancing the reporting, organization, and transparency of health care data.
Discussions on the latter sparked heated debate among
not like purchasing a loaf of bread or a gallon of ice cream, where every loaf or gallon is the same. Every patient comes in with a different health re- cord, a different manifesta- tion of even the same disease, and you can’t make them the same. Nor do patients want to be treated the same,” she said. As Texas looks for ways to stymie increasing health care costs and to improve health care delivery, that answer struck at the heart of recent recommendations by a state- appointed advisory board tasked with evaluating the role of transparency in the equa- tion, among other factors. The 2011 legislature created the Texas Institute of Health
Care Quality and Efficiency under the state’s own version of health system reform, Senate Bill 7. Dr. Strate was among a group of 15 appointed health care experts directed to study and report back to the legislature on three broad areas:
• Improving the quality and efficiency of health care delivery by developing things like reportable measures;
“Purchasing health care is not like
board members in their charge to more specifically look at whether requiring physicians to publicly report the payment amounts they accept for spe- cific services — and to stick to them — could help con- sumers make more informed health care decisions. A majority of the institute’s
purchasing a loaf of bread or a gallon
of ice cream, where every loaf or gallon is the same.”
board ultimately rejected the proposal in its Nov. 30 report to the legislature. Instead, they pointed to existing rem- edies that allow physicians, hospitals, and health plans to estimate patients’ out- of-pocket costs, and recom- mended additional solutions that encourage patients to seek that information ahead of treatment. Still, as the report makes
its way into lawmakers’ hands, the idea is likely to resurface this legislative session. Transparency in health care pricing is just one part
of improving the overall health care delivery system, but an important one, says Rep. Lois Kolkhorst (R-Brenham), chair of the House Committee on Public Health. Armed with payment information, “patients might
make more investments in their health care, and [lawmak- ers] could see where the big dollars are being spent,” she said. “There’s a concern we are creating a more opaque sys- tem versus going the other direction, and this is just a start- ing point. There is no silver bullet to fix the health care system, but these are conversations that need to be had.”
March 2013 TEXAS MEDICINE 35
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