Financial Accountability

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Financial Accountability Transparency in Health
Care
October 2006
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Task Force Findings

• Consumers need and deserve better information on
  which to judge value among their treatment
  options
• Hospital charges are relevant for some, but only
  if put in proper context and paired with quality
  information
• For uninsured, easier access to financial
  assistance policies and related staff resources
  are key

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Task Force Findings

• Health plans are developing and implementing a
  variety of tools and resources for their policy
  holders, including negotiated price ranges for
  common procedures and some quality information
• Only health plans are in a position to answer the
  out-of-pocket bottom line for insured
  population, as consumer costs are tied to the
  specifics of their plan
• But most health plan efforts are in early stages,
  and vary in detail and ease of use
• Opportunity exists to step forward with hospital
  price and quality information, drawn from
  existing data sources, to address policy maker
  demands and some consumer needs.

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Summary Recommendations

• VHHA sponsored hospital site
• Virginia version of WHA program
• Hospital charges in context
• With links to CMS-collected quality data and
• links to hospital financial assistance policies
  and related staff
• Partner with other stakeholders on development of
  a transparency portal
• Outpatient data, LTC and pharmacy information
• Links to hospital and health plan programs for
  more detailed data
• Voluntary effort sought by Governors office and
  legislators
• Pursue collaboration among hospitals and plans on
  administrative data exchange
• Clear cost-savings opportunity for both parties
  (5 to 25 cents per transaction, across millions
  of transactions)
• State executive branch champion

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Transparency Timeline
PHASE I
PHASE II
PHASE III

• Virginia Price Point site
• Links to hospital Financial Assistance Policies
  and staff
• Link to CMS Quality Site

• Simplified Cost Estimator
• Bundled Prices
• Hospital Physician
• Expanded Outpatient Services
• Further quality enhancements

• WHA Enhancements
• Quality Enhancements
• Other Health Care facilities
• Link w/ collaborative Virginia portal

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URL www.vapricepoint.org
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Transparency Timeline
PHASE I
PHASE II
PHASE III

• Virginia Price Point site
• Links to hospital Financial Assistance Policies
  and staff
• Link to CMS Quality Site

• Simplified Cost Estimator
• Bundled Prices
• Hospital Physician
• Expanded Outpatient Services
• Further quality enhancements

• WHA Enhancements
• Quality Enhancements
• Other Health Care facilities
• Link w/ collaborative Virginia portal