Not so transparent: Health care data hard to define

Everybody wants a clear view of the cost and quality of health care. But defining this "transparency" is not an easy task -- and it's one physicians, insurers and the federal government continue to struggle with.

By Jonathan G. Bethely, AMNews staff. Nov. 20, 2006.

These days there's a lot of talk about making the cost and quality of health care more understandable to patients. But this transparency, like beauty, is in the eye of the beholder. While physicians and insurers each express support for transparency, there is a battle over what measures and techniques should be used to achieve it. Even the definition is in flux.

Insurers trumpeting transparency say they make every effort to ensure that the price and quality information they release gives consumers the clearest picture of the best doctors, the least expensive doctors and the best combinations of both.

But there's concern among physicians that without their clear direction and input, transparency initiatives might mislead patients into thinking that plans are paying doctors more than they actually are and that physicians are overcharging. Physicians also worry that plans are not using the correct and most complete information to rate quality, thus misrepresenting doctors, particularly those who take high-risk cases.

"Cost and efficiency is so hard to define," said Molly Katz, MD, immediate past president of the Ohio State Medical Assn. and a Cincinnati ob-gyn. "Perception of those things is different in everyone's eyes. Physicians don't mind saying, 'This is what I charge.' But comparing what you charge to the next person is very hard to quantify."

The issue of transparency has gotten more traction as patients have become responsible for more of their health care costs through increased PPO deductibles or consumer-directed health plans.