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Motivation Needed to Improve Price Transparency in Iowa

Iowa Report Card on Price TransparencyIn Iowa, we can do better. Indeed, we must, as we really can’t get any worse.

Report cards are important for many different reasons. Whether for students, organizations, institutions, legislators, communities or countries, report cards can summarize overall progress by using comparable benchmarks that use similar metrics. If generated appropriately, report cards can serve as a motivator to improve on less-than-desired results – and behaviors.

While attending parochial school in Fargo, N.D., my third grade report card was…embarrassing. Ok, it was downright atrocious. Most subject matter grades were usually ‘Ds.’ My care-free attitude reflected that school was not a central priority for someone my age. In fact, it seemed that many of my friends were equally unmotivated to elevate their grades. When I did care, I would only compare my grades with my closest peers. In that regard, I was still below average.

Report card comments stated that I ‘needed to improve my attitude.’ Fair enough. But it took me another three years to eventually become tired of having less-than-exemplary grades, especially when I began to compare my grades with a broader audience of classmates who had greater academic aspirations. This delayed ‘epiphany’ pointed me in a new direction of pursuing better results – and, I might add, making my parents happier!

Embracing this new transition required a motivation that would alter my behavior(s) to perform differently. To elicit a positive change, finding the ‘right’ motivation is tricky. It must cause a person, organization or community to repeat certain behaviors and actions over and over before it finally becomes ingrained in who we ultimately wish to become. Whether you’re a student pursuing employment after graduation, becoming the employer of choice, or being the healthiest community, motivation is key. Our attitudes, beliefs, intentions and efforts will ultimately drive the cycle of desired change.

In this vein, I was keenly interested in learning about the newly-released the ‘2016 Report Card on State Price Transparency Laws’ by the Health Care Incentives Improvement Institute (HCI3) and Catalyst For Payment Reform (CPR) that graded each state on healthcare price transparency laws. I will refrain from specifics, other than only three states (Colorado, Maine and New Hampshire) earned an “A,” one (Oregon) received a “B,” two (Virginia and Vermont) given a “C,” while one (Arkansas) received a “D.” What about the other 43 states? According to HCI3, they all failed.

The 18-page Report Card provides a good overview on this subject for each state. Each high-scoring state provides a legislated website that shares consumer-friendly resources in formats that are relevant to healthcare prices.

What about Iowa?

Based on this report card, it appears that Iowa must make improvements to:

This report card serves as just one measure – price transparency. The quality of care received by patients is not measured.

APCDs may collect data from all state sources including Medicaid, private health insurers, children’s health insurance and state employee health benefit programs, prescription drug plans, dental insurers, self-insured employer plans (ERISA) and Medicare.

APCDs are often believed to be the best price information resource because they include actual paid amounts, not merely charged amounts. Until we can get real-time ‘settled’ prices by provider for each procedural event, APCDs may be the best option, although somewhat problematic, due to a recent Supreme Court ruling. Some insurers may offer their own ‘transparency’ tools for their customers. However, limitations make it a ‘buyer beware’ proposition when it comes to paying the final price – given the specific medical procedures and services that are eventually delivered.

According to this report card, Iowa has received a failing grade on price transparency tools for the healthcare ‘consumer.’ The question for employers and their employees, along with other payers and consumers of healthcare: Is this grade acceptable? Are we better served clinging to the past and continuing to blindly shoot in the dark while purchasing care?

Iowa can choose to be led by more forward-thinking states that appear to be trendsetters in price and quality transparency initiatives, or we can decide to break from the masses and choose a new mindset to improve a nagging problem that continues to persist for our population.

It’s about having the right motivation and behavior. Most importantly, it is about having the will to break through complacency and self-interests. The word ‘transparency’ is frequently used in healthcare – whether spoken or written – but unfortunately, it is underutilized in the practices and policies in which we live.

Seeking and finding the right motivation and behavior can be done. Take it from a ‘reformed’ third grader!

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