The Leapfrog Group was invited to testify at the United States Senate Committee on Health, Education, Labor and Pensions’ (HELP) hearing on September 18, 2018 to share the perspective of employers and other large purchasers of health care on the important role transparency plays in improving American health care.
In her testimony, Leapfrog President and CEO Leah Binder emphasized how Leapfrog has demonstrated that transparency galvanizes major improvement in quality and safety, and more and more consumers rely on information about performance to make decisions about health services. She expresses criticism of the CMS “Meaningful Measures” initiative because it focuses on the burden hospitals face, not the burden consumers and purchasers shoulder from poor quality and increasing prices. She cautions that the movement for good measurement is the bedrock of transparency, yet still relatively fragile and new. Binder says full transparency combines pricing information with quality—price alone won’t change things. She thanked the Senate HELP Committee for its bipartisan leadership on health care and recommended three main policy principles:
1. Put Safety First. Patient safety problems are third leading cause of death and a major, if often hidden cost driver. It nullifies equations of value and quality or good pricing, and concerns consumers deeply. CDC should make its data on infections and other safety issues public.
2. Price Transparency Alone Can Backfire. Couple it with quality ratings, because quality determines spending. A procedure may be offered at a good price, but it is no bargain if 1) the patient suffers from an infection or medical error, 2) the procedure wasn’t needed in the first place, or 3) the procedure is poorly performed and has to be corrected. The National Academy of Medicine estimates that one-third of health spending is wasted, mostly on one of those three issues.
3. Don’t Kill the Measurement. The movement to create and endorse good measures is relatively young and fragile, yet already there are efforts to cut it in the name of “parsimony”—frugality not applied to the actual excess measures are designed to root out. We need a framework for measurement that pivots on consumer needs, not industry preference. And we need more public-private alignment to get and use the right measures, including more federal engagement with Leapfrog and efforts like ours.