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Decision-Support Tools Provide Insufficient Data
A report released this month by the California HealthCare Foundation examines the decision-support tools that are currently available to help consumers choose health plans and providers. Consumers in Health Care: Creating Decision-Support Tools That Work also reviews the evidence for various tools' effectiveness and suggests strategies for promoting their use. The foundation also released a related report, Health Care Cost Comparison Tools: A Market Under Construction, which found that the online tools available to consumers do not go far enough to enable them to comparison shop for their medical care. However, the continued shift of medical costs from employers to consumers and the growth of consumer-directed health plans are expected to spur further advances in these tools.

Mass. to Post Hospital, Drug Prices Online
Specific information on the quality and cost of health care provided by Massachusetts hospitals will soon be available on the state's Web site, according to a recent Associated Press article published in The Boston Globe. Current data on the state's Web site rank institutions in one of three categories based on their comparative costs. Under a key provision of Massachusetts' new health care reform law, the site also will list the average payment each institution charges for services, including office visits, diagnostic tests, and surgeries, as well as prices charged for prescriptions at individual pharmacies. The state will collect billing data from major insurers for the site—a plan that is drawing criticism from hospitals because it fails to include actual care data available from clinical records. Other states have similar information available: a New Hampshire site includes the costs of certain procedures and operations and Florida consumers can compare pharmacies' prescription drug prices on a Web site developed by the Florida Attorney General and the Agency for Health Care Administration.

Error Prevention

Hospitals Enlist Patients to Increase Drug Safety
New national patient-safety standards, effective in January, require hospitals to have a set routine for collecting complete drug and allergy histories and comparing them with new medications that doctors order. According to a recent Wall Street Journal article (subscription required), hospitals have responded to this requirement by stepping up efforts to educate patients and families about their role in the medical reconciliation process. Though the eventual goal is to store patients' medical histories online, right now they're turning to medication forms. In Arizona, hospitals and physician practices have come together to support The Med Form, which contains basic information about patients, their allergies and drug reactions, current medications, and immunization history. Others medication forms include the "Universal Medication Form," available online from hospitals and groups such as the South Carolina Hospital Association, and My Medicine List, developed by the Minnesota Alliance for Patient Safety. Another program, Vial of Life, offers medication forms that patients can store in an empty bottle in the refrigerator, along with a bright red sticker for the door to alert emergency responders.

Health Care Disparities

QIOs: Report Finds Interventions Reduce Disparities
A report released last month found that Quality Improvement Organization (QIO) interventions reduced disparities from 13.6 percent to 8.5 percent overall, principally among African Americans, Hispanics, Native Americans, and rural residents. Specifically, efforts to reduce disparities in diabetes care in 23 states resulted in an improvement of 1.6 percentage points for selected measures, representing a 33 percent relative increase over baseline. Also, efforts to improve care for African Americans in 22 states or territories resulted in a median absolute improvement of 7.5 percentage points, representing a 26 percent relative improvement. Overall, 49 of 52 states and territories demonstrated an absolute improvement in quality measures for the underserved population, and 46 of 52 saw a reduction in disparities. Based on these results, "QIO Efforts to Reduce Healthcare Disparities, 2002–2005" calls on Medicare to: increase spending to reduce disparities; include other care settings such as nursing homes and home health agencies in such efforts; address disparities under the new Medicare prescription drug benefit; and consider combining Medicare and Medicaid data to address the disparities found among dual-eligibles.

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