Healthcare Analytics : Analytics Drive Transparency Efforts
November/December 2013
Healthcare Analytics
Analytics Drive Transparency Efforts
A variety of initiatives are dragging U.S. healthcare kicking and screaming from a system where performance data is a closely guarded secret to one where transparency is the norm.
The Institute of Medicine defines transparency as “making available to the public, in a reliable and understandable manner, information on the healthcare system’s quality, efficiency and consumer experience with care, which includes price and quality data, so as to influence the behavior of patients, providers, payers and others to achieve better outcomes (quality and cost of care).” To simplify, if a buyer can’t easily understand the differences in price and quality between suppliers (i.e. how much does an MRI cost, what will my hip replacement cost, how does my hospital rate on patient safety measures?) or easily obtain information about their treatment options, then they are unable to make the best choices about their care.
You wouldn’t purchase a car without first understanding the features, safety rating, or cost, so why should that be any different with healthcare? This is where transparency comes into play, and there are three core benefits to help drive better outcomes and improve our healthcare system:
- Consumer choice. Vital in any market, when consumers have the information they need, they can make better-informed decisions about the services they receive. This can change incentives across the board, as healthcare payers and providers are faced with more competition. For example, after New York State began publishing outcomes data for coronary artery bypass grafting (CABG) in 1989, the state’s CABG mortality rates fell by more than 40%; furthermore, the hospitals with better outcomes began to see growth in their market share.
- Increased accountability. Transparency also makes healthcare stakeholders more accountable for their actions. For example, with open data we can identify if a particular hospital has unusual mortality rates or if a Medicaid managed care entity is providing the required preventive care to its members.
- Improved performance. Transparency drives performance. Imagine if, as a student in high school, your test grades were posted publicly for everyone to see and you continuously received one of the poorest grades in the class. What would you do about it? Well, studies have shown that the potential for scrutiny by peers is sufficient in itself to incentivize behavioral change. And of course, no physician or healthcare delivery organization wants to be known as having the poorest grades in the class.
While we’ve touched on the benefits of transparency, it’s not possible to achieve this without data, and that’s where health analytics is playing an increasing role. Given the numbers of health and life science customers using analytics to drive transparency— and ultimately improve healthcare quality, costs, and safety—we’re cautiously optimistic about the future of our healthcare system. To elaborate, we’d like to share two current industry initiatives with you.
Publishing Cost and Quality Information
Many states are actively working to pursue transparency initiatives through development of all-payer claims databases (APCD) and by publishing hospital price lists. The need for these efforts is not ill-founded. Earlier this year, The New York Times published a compelling piece on price variations for common procedures around the world and stated, “In many other countries, price lists of common procedures are publicly available in every clinic and office. Here, it can be nearly impossible to find out” (Meier et al., 2013). In fact, 29 states actually received a failing grade in healthcare price transparency according to a study from the non-profit Healthcare Incentives Improvement Institute and Catalyst for Payment Reform released earlier this year. And, only two states received “A” grades – Massachusetts and New Hampshire.
States are developing APCDs to shed light on the actual costs of healthcare services, help states understand and identify variation in payment and quality across plans and providers, and promote informed decision making across the entire healthcare system. States that see the value of healthcare cost data understand how transparency of healthcare information leads to improved quality of care for their population.
Clinical Data to Further Research
And in the pharmaceutical industry, organizations that are often viewed as competitors are working together to contribute anonymized clinical trial data into a globally accessible cloud environment to aid researchers. An effort led by the CEO Roundtable on Cancer’s Life Sciences Consortium is the Project Data Sphere initiative—a platform providing an easy-to use research sanctuary to responsibly access, share, and analyze cancer clinical trial data designed to accelerate cancer research. The initiative has welcomed stakeholders in the cancer community to advance science through the transformation of “big data” into new solutions for improved cancer patient care.
To successfully transform our healthcare systems, transparency can no longer be a “nice-to-have”—it’s a required imperative. As stakeholders see the value of analyzing rich data, the life cycle will mature naturally. The important part is that we build a vision for analytics and don’t leave analytics out of consideration when implementing these systems.
How is your organization or state using analytics to be more transparent in improving healthcare price and quality?
Graham Hughes serves as chief medical officer on the SAS Center for Health Analytics and Insights team. He joined SAS in 2011, bringing to the organization more than 20 years of experience in developing and delivering innovative healthcare information technology (IT) products and services. Prior to joining SAS, Graham spent six years working as vice president of product strategy and chief medical informatics officer at GE Healthcare IT, leading a customer-facing advanced technologies innovation team, as well as spearheading the annual strategic planning process. He may be contacted at graham.hughes@sas.com.
Krisa Tailor is product manager for the SAS Health & Life Sciences Global Practice, responsible for the development of new healthcare offerings and global healthcare strategy. Her research interests include healthcare price transparency, policy diffusion, payment reform, and health data visualization. She may be contacted at Krisa.tailor@sas.com.
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