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ADVOCACY SPOTLIGHT


Advocating for Transparency in Health Care ASCA works with legislators for patient access to health care data BY JEFF EVANS


Access to health care infor- mation 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 informa- tion 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 avail- able to consumers on prices, out-of- pocket costs and quality?


■■


What information is not currently available, but should be made avail- able to empower consumers, reduce costs, increase quality and improve the system?


■■


How do we advance greater aware- ness and usage of quality informa- tion 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 cost- efficient for stakeholders to provide high-quality care to patients?


■■


How can our health care system bet- ter utilize big data, including infor- mation 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, qual- ity and outcomes across the health care system. To this end, the association


ASCA believes that patients should have the ability to compare cost, quality and outcomes across the health care system.”


— Jeff Evans, ASCA


advocates to state and federal lawmak- ers 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 ben- eficiaries to compare ASCs and hos- pital 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


18 ASC FOCUS AUGUST 2018|www.ascfocus.org


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., hos- pital 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 Sec- retary 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 com- pare 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, conve- nient and cost-effective care to mil- lions 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 Sen- ator Cassidy, ASCA steadfastly advo- cates 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 con- tinue to monitor this issue as it gets increasingly more attention on Capitol Hill and in the regulatory agencies.


Jeff Evans is ASCA’s assistant director of government affairs, legislative affairs. Write him at jevans@ascassociation.org.


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