Is Transparency Important In Healthcare?

Yes! Transparency is an important factor in daily business and that is true in healthcare as well. At NMC, we hold quarterly “town meetings” and “ask us anything” sessions to share information with our staff and answer any questions they may have. Our website features a “hospital report card” so our community can see how we are performing. Part of that report card is a State report on comparative hospital pricing. NMC typically fairs well, in terms of being at or below the State average in charges for our common inpatient and outpatient procedures. Still, with the Medicaid Cost Shift, even these numbers are not truly transparent. The cost shift masks what we would be charging if Medicaid and Medicare paid the cost of the care they promise their enrollees. It creates confusion regarding “how could that cost that much” for people unfamiliar with the cost shift. Therefore, NMC has consistently advocated for a reduction in the cost shift as part of healthcare reform to allow for greater transparency in the actual cost of care.

We are joined in this effort by the other not-for-profit hospitals in Vermont. Our association is working hard to be among the leading advocates for overhauling the health care system. My colleagues and I believe “that providing clear information to all Vermonters regarding the cost of care they receive is an important part of our work to build a health care system that provides all Vermonters access to the highest quality care they can afford.”

The Vermont Association of Hospitals and Health Systems recently released a statement on pricing transparency, which said, “Because this information is critical to patients, we appreciate the Legislature’s work to address this important aspect of health care. To help reduce costs and improve quality, price transparency initiatives must be done as part of the more comprehensive payment reform effort. We must work together to transform the health care payment system so we can compensate health care providers based on quality of care rather than quantity of services. This critical change will better enable doctors and nurses to focus on what’s best for keeping patients healthy. From preventing hospitalizations to supporting patients after they’ve gone home, payment reform – of which price transparency is one component – is an essential step toward an affordable health care system.”

Our statement went on to say, “Vermonters understand each individual patient experience is unique. There are many factors that influence costs from patient to patient and provider to provider. Providing understandable pricing information helps Vermonters to make more fully informed decisions. Simplifying and streamlining Vermont’s health care pricing and payment systems – focusing payments on quality, instead of quantity – will lower costs over time. For these reasons, we support the work the Legislature and the Green Mountain Care Board are doing regarding the issue of price transparency, as well as their broader efforts to keep health care reform moving forward.”

As I discussed in an earlier column, Vermont must take an informed, strategic approach to the cost shift. We must ensure that an announced reduction actually flows through the provider and insurance system to businesses and individuals in the form of reduced premiums for commercial insurance. Similarly, the strategy used to address the cost shift should not create an even greater burden on those it is intended to help. This is a challenging task, particularly given the status of the State budget. It will require looking very closely at both how we pay for Medicaid services, what services are covered, and how costs can be reduced in providing those services. NMC is an active participant in cost reduction efforts and continues to work to reduce avoidable visits to our Emergency Department, to use LEAN techniques to eliminate duplication and waste, and to continue to invest in prevention to reduce the demand for more costly healthcare services.

The Legislature and the Green Mountain Care Board are working hard on this important issue and I encourage all of you to join me, NMC, and Vermont’s not-for-profit hospitals in paying close attention to it and in providing input to them to help guide their efforts to create a more transparent, effective, and cost efficient system for providers to care for our community.

— Jill Berry Bowen, NMC’s Chief Executive Officer