Posted on July 27, 2017

Immediate Release

Media Contact: Caroline Steinberg

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Report Calls for Better Tools to Produce Wiser Decisions, Lower Costs, and Improved Outcomes

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Choosing a doctor, hospital, health insurance plan, or a course of medical treatment can be among the most daunting and critical decisions that consumers make. Most consumers and patients make these decisions without proper information or support – a situation that can lead to higher costs, lower quality, and care outcomes that don’t match individuals’ goals and preferences, according to a new report by NEHI (The Network for Excellence in Health Innovation).

The remedy is a 9-step “priority roadmap” for greater transparency in health care and other measures that will help consumers make more informed decisions, NEHI concluded. 

“Our report – “Transparency in Health Care: A Priority Roadmap for Consumer Engagement” – found that helping consumers make well-informed decisions can lead to higher quality of care, greater patient satisfaction, and a far better use of the nation’s health care resources than would otherwise be the case,” said Susan Dentzer, president and CEO of NEHI. “All stakeholders in the health care system should push for more transparency in health care costs, quality, and outcomes, and with it, better consumer education on the consequences of their health care choices.”

Among the report’s findings and recommendations are the following:

  • Consumers generally don’t understand that they may face multiple treatment options for a given condition that may or may not match their own preferences. They’re also typically unaware that health care costs can vary widely for the same service, often with little or no correlation to quality. To address these issues, NEHI’s report calls for a broad public awareness campaign on health care choices and consequences. It also recommends steps to spur “shared decision-making” between patients and providers, including extending some liability protections to physicians who engage their patients in a careful process of jointly considering various treatment options.

  • There are multiple tools to help guide consumers through their decision-making, such as choosing a physician or a health plan, but these tools are not uniformly available or useful. Even when they are, consumers are typically unaware that these tools exist, don’t use them, or find them difficult to understand. Most consumers want cost, quality, and treatment information that is highly personalized to their condition, insurance coverage, and preferences, and delivered at the time they have to make decisions. NEHI’s report thus calls for simpler tools focused on consumer information priorities, better marketing of tools to consumers, and increased availability of tools across all populations at key decision points.

  • Amid current trends in health insurance, such as the growth of narrow provider networks, restrictions on coverage for prescription drugs, and the rise in deductibles and other consumer cost-sharing, the wrong decision in selecting a health plan or provider can have costly consequences for consumers.  NEHI recommends that policy-makers pass laws that hold plans and providers accountable for the accuracy of the data that they publish in provider directories and other materials, and that protect consumers from the financial consequences from acting on bad data.  Public and private tool developers should build on lessons learned from the tools that support consumer choice among plans on the Affordable Care Act exchanges.  Laws and regulations also should support the development of tools that allow consumers to determine their specific cost-sharing responsibility based on negotiated payment rates between plans and providers. 

The full list of 9 recommendations in NEHI’s priority roadmap can be seen in the Executive Summary at the beginning of the report.

 “Implementing NEHI’s proposed transparency roadmap will support consumers in making informed decisions,” said Caroline Steinberg, vice president of programs at NEHI.  “Understanding the variables will help consumers make the best choices,” she said. “Lack of accurate and timely information can lead to ‘surprise bills,’ if a consumer unwittingly strays out of network, among other harms consumers may face.”

Find out more about NEHI’s recommendations in Transparency in Health Care: A Priority Roadmap for Consumer Engagement and read our blog.

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