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Price Not Equal to Quality, Study Finds

A study published in January in Health Affairs shed some light on one of the more opaque corners of U.S. health care: the prices insurers pay to hospitals, which differ from the list prices that the Centers for Medicare and Medicaid Services (CMS) released last year. The results are based on an examination of 25,000 claims filed by autoworkers in 10 cities for services from 110 different hospitals. Researchers found that high-priced hospitals tended to: 1) be larger teaching hospitals, 2) belong to health systems that control large market shares, and 3) offer specialized services, such as heart transplants. The study also found that pricier hospitals generally performed worse than low-priced hospitals on common indicators of quality, such as keeping patients from being readmitted and avoiding blood clots and death among surgical patients.

Hospital Engagement Networks Having an Impact

The efforts of thousands of U.S. hospitals participating in one of 26 hospital engagement networks, or HENs, are yielding substantial returns in terms of safer care and averted costs, according to an announcement from CMS and the American Hospital Association last month. The hospitals, which are receiving training and technical assistance to prevent harm and help patients heal without complications, are credited with improving care for some 69,000 patients—by avoiding health care–associated infections and falls, reducing early elective deliveries, and other improvements. The program has also reportedly saved more than $200 million over the past two years.

Quality Data Now on Physician Compare

For the first time CMS is publicly reporting data on the quality of physician groups and accountable care organizations on its website, Physician Compare. The measures that are now posted report on physicians’ adherence to recommended care guidelines for patients with diabetes, heart disease, and other conditions. Physician Compare, created through a provision of the Affordable Care Act, had previously included only information about physicians’ specialties, certifications, and affiliations.

Large Pharmacy Chains Back Blue Button Initiative

Walgreens, Kroger, CVS Caremark, Rite Aid, and Safeway pharmacy chains have committed their support to the Blue Button initiative, a public–private effort to create tools that give consumers online access to all of their health care data—including medical records, prescriptions, laboratory reports, claims, and other sources—in one easily accessible portal. According to the February 7 announcement from the Office of the National Coordinator for Health Information Technology (ONC), the companies have agreed to standardize patient prescription information to make it accessible via Blue Button tools. Some 150 million Americans already use such tools to access their health information, and the ONC recently released Blue Button+, a set of technical guidelines to enable providers to structure their data in machine-readable formats. And beginning this year, providers participating in the federal program to promote "meaningful use" of electronic health records will have to begin to move toward Blue Button standards for structuring health information.

Trends to Watch in 2014

In a Health Affairs blog post last month, Susan DeVore, president and CEO of Premier—an alliance of hospitals, health systems and other providers working to achieve high-value care—lists trends to watch in health care in 2014, beyond the much-reported changes to insurance coverage. Among these, she cites an intense focus on chronic care management, along with accompanying changes in the health care workforce (e.g., a growing reliance on health coaches); continued expansion of telehealth and workplace wellness programs; a push for open-source and interoperable health data platforms; and emerging partnerships among providers and social service agencies, gyms, faith communities, and others from outside of health care.

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