GAO says Medicare, Medicaid cost-comparison tools too influenced by providers

Transparency tools that allow prices and quality of goods and services at competing suppliers to be compared save consumers billions of dollars but it’s a different story in the federal government, according to a congressional watchdog.

“The Centers for Medicare & Medicaid Services operate five transparency tools — Nursing Home Compare, Dialysis Facility Compare, Home Health Compare, Hospital Compare and Physician Compare — that are limited in their provision of relevant and understandable cost and quality information for consumers,” said the Government Accountability Office in a report made public Tuesday.

“In particular, GAO found that the tools lack relevant information on cost and provide limited information on key differences in quality of care, which hinders consumers’ ability to make meaningful distinctions among providers based on their performance,” said the report by the congressional watchdog agency.

“Because none of the tools contain information on patients’ out-of-pocket costs, they do not allow consumers to combine cost and quality information to assess the value of health care services or anticipate the cost of such services in advance,” the report said.

The report also criticized the Medicare and Medicaid cost-comparison tools for “substantial limitations,” including “not using clear language and symbols, not summarizing and organizing information to highlight patterns, and not enabling consumers to customize how information is presented.”

In the private sector, GAO said it found “the cost for maternity care at selected acute care hospitals in Boston, all of which rated highly on several quality indicators, ranged between $6,834 and $21,554 in July 2014.”

But GAO said the government’s tools for Medicare and Medicaid cost comparisons are “heavily influenced by the concerns of providers rather than consumers.”

As a result, GAO said, “without procedures or metrics focusing on consumer needs,” the government “cannot ensure that these efforts will produce cost and quality information that is relevant and understandable to consumers seeking to make meaningful distinctions.”

Go here for the complete report.

Mark Tapscott is executive editor of the Washington Examiner.



Related Content