American College of Physicians expresses support for executive order on health care transparency

Notes organization's recommendations already made to White House

The American College of Physicians (ACP) today expressed its support for the goals of the executive order signed by President Bush, noting that the ACP has provided the White House with detailed recommendations on introducing transparency in health care decision-making

The executive order is designed to help people make more informed decisions about doctors and hospitals. Following a talk Tuesday with health care providers about "health transparency," President Bush ordered four federal agencies to compile information about the quality and price of care they pay for and share that information with customers and each other. In May, 2006 ACP provided the White House with detailed recommendations on how to structure programs to inform consumers about the quality and cost of care provided by individual physicians (http://www.acponline.org/hpp/price_trans.pdf). ACP also provided similar recommendations to the House Ways and Means Committee for the record of a July hearing on transparency.

ACP's recommendations to the White House and Congress emphasize:

• the distinction between the price a physician charges for a service, the amount of reimbursement a health plan allows towards a covered service, and the total cost of care associated with a particular episode of illness;
• the importance of developing quality and cost of care measures through a transparent, evidence-based, and multi-stakeholder process like the AQA;
• short and long term steps that Medicare and individual physicians can take to provide patients and beneficiaries with information on quality, the fees charged for specific procedures, and the cost of care.

Lynne Kirk, MD, FACP, president of the ACP, said physicians support more transparency because both physicians and patients will benefit from having access to reliable and evidence-based measures of quality and cost. She urged the administration to continue to work closely with ACP and other stakeholder organizations on developing transparent and evidence-based measures of both quality and cost that recognize the complexities involved.

"ACP is committed to continuing to work through the AQA to select appropriate, evidence-based, and transparent measures of quality and cost of care," Dr. Kirk explained. "Development of cost of care measures is still in its infancy. It is essential that such measures be based on the best clinical evidence available on the resources required to provide a defined level of high quality care. The process of selecting such measures must itself be transparent."

"Disclosing the fee charged by a physician may help inform patients' decision-making for non-urgent elective procedures, but it will not by itself help patients predict their total cost of care for complex illnesses or evaluate the quality of service provided." said Dr. Kirk. "As a group that represents some 120,000 internal medicine physicians, related subspecialists and medical students, it is incumbent upon us to work with the administration to assure that any information provided to the public is accurate, reliable, relevant, and understandable."

Tuesday's executive order directs the Department of Health and Human Services, the Department of Defense, the Veterans Administration and the Office of Policy and Management to:

• Use, where available, health information computer systems that can talk to each other.
• Enact programs that measure the quality of care, and develop those measures with the private sector and other government agencies.
• Make available to beneficiaries the prices that agencies pay for common procedures.
• Develop and identify practices that promote high-quality health care.

The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. Internal medicine physicians specialize in the prevention, detection and treatment of illness in adults.

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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