Massachusetts Quality and Cost Council - MyHealthCareChoices Site Unveiled

Massachusetts’ Health Quality and Cost Council has just unveiled its new public transparency web site, MyHealthCareOptions, which is available at http://hcqcc.hcf.state.ma.us/.   The state has taken claims data from the major commercial health plans, and ascertained cost of care by hospital for a limited number of procedures. It has also assembled related quality data, generally from different sources (since it’s hard to determine quality through claims alone).  This was a big effort, and the web site allows patients to filter by geography and compare up to 4 hospitals. Where possible, there is notation of level of statistical certainty.   (For instance, a low volume hospital might have an apparently high cost, but this would be more likely to be due to chance rather than a real difference).


It’s a good start – but the data available on cost is limited to 1-4 stars (representing top 15% of cost, above average, below average, and bottom 15% of cost.  Actual dollar numbers and relative prices, as displayed in a Globe article a few weeks ago, would be more meaningful than percentiles.  Some additional information  I’d like as a consumer which is not currently displayed includes: 

  • Patient experience by service, rather than hospital-wide
  • Volume for surgical procedures, where more volume often leads to higher proficiency
  • Rate of caesarian section by hospital.  While there is no “right” rate, some women might prefer to go to a hospital with lower C-section rates.


It’s also impressive how often there is no generally accepted quality data.  It’s hard to describe “value” when we only know the cost and don’t have a good way to ascertain the quality of the health care we purchase.


Who will look at this web site?    My own experience is that it will be reviewed largely by providers rather than consumer – and that’s just fine.  The site might make some hospitals feel pressured to implement some safety processes (like computerized physician order entry) and work harder to improve patient experiences.    The site might help pressure some organizations to accept lower rate increases, although it’s also likely to make many single $ institutions push much harder for large rate increases.  


 ADDENDUM: Young Joo, a student in our HSPH class, has worked on staff of the Health Care Quality and Cost Council.   He did some of the statistical work underlying this web site. He points out  that by clicking on "show details" you can get median, 85%ile, and 15%ile of costs where available for each of the listed procedures.   This tool also allows you to see the state median, 85%ile and 15%ile -- so you can see where the $ ratings come from.  

 
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