Doc shopping gets easier

By Jennifer Heldt Powell, BostonHerald
Sunday, April 9, 2006 - Updated: 10:57 AM EST

First in a two-part series on how the health-care reform bill affects you and your business.
    Massachusetts consumers may be able to shop for a doctor in much the same way they do for an airline, car or hotel room under the massive health-care reform bill approved by lawmakers last week.
    The plan calls for a user-friendly Web site that will provide information about cost and quality. Some day, patients may be able to even compare how much doctors charge for physicals and how well they do at treating certain diseases.
    ‘‘Right now, this information is virtually impossible for consumers to get in any way they can understand,” said Cort Boulanger, spokesman for the Massachusetts High Technology Council. ‘‘Even if you wanted to be a smart consumer of health care, you probably wouldn’t be able to do it.”
    It’s called ‘‘transparency,” and it’s critical to lowering health-care costs, say proponents of the relevant pieces of the reform bill.
     Even those critical of the overall bill say they like this part of it. It has drawn support from all sides of the debate - providers, consumer advocates and health insurers.
    ‘‘You have the potential to create a Bureau of Labor Statistics for health care,” said Charles D. Baker Jr., chief executive of Harvard Pilgrim Health Care.
    The labor bureau’s data is crucial for understanding the economy and is used in numerous ways. The health-care data could be equally important, he said.
    Consumers could use it to compare hospitals, specialists and primary-care doctors. Doctors and hospitals make improvements based on their comparisons to others. Insurers could design plans for favoring high-quality, low-cost providers.
    ‘‘There are cost differences in health care now that are not justified by performance and that’s because there is no public discussion about it,” Baker said. ‘‘It will force people who have the very highest prices without any obvious rationale to justify their price position.”
    Health plans now collect some quality data, but very little of it is made public. The overall information is limited because it covers only a small portion of patients.
    The state’s system is intended to capture data from every doctor on every patient regardless of who pays the bill.
    While many like the idea, no one disputes the challenge.
    It took the Group Insurance Commission, which buys insurance for state employees, two years to set up a similar system that just covers the insurance plans with which it works.
    Health plans are just now using the information collected to create tiered coverage options. Patients get a financial break if they go to doctors who get high scores on a combination of quality and price.
    ‘‘It’s a formidable task,” said Dolores Mitchell, longtime chief of the GIC.
    When the GIC plan was first announced, providers were extremely concerned about what measurements would be used. They still are, although they say the benchmarks are getting better.
    ‘‘This is a young science, we want to get it right,” said Dr. Alan Harvey, Massachusetts Medical Society president. ‘‘We want to make sure that it’s accurate and relevant.”
    The Web site will be guided by a commission of state officials, health-care providers, insurers and patient advocates. There will also be an advisory group to guide the work.
    The biggest hurdle is determining what should be presented and how, said Dr. Thomas Lee, chief of Partners HealthCare System’s physician network.
    ‘‘This area is a bit of a blank slate,” he said. ‘‘There will be a lot of contentious meetings.”
    There are many challenges when trying to compare providers. For instance, some hospitals, such as Partners’ Massachusetts General, may charge more because they provide more care to uninsured patients.
    The performance of doctors could be affected by the level of illness in the patients they see.
    ‘‘You don’t want to penalize physicians for taking care of sick patients,” he said. ‘‘Otherwise, they may respond to the measurements by saying they don’t want to take swings outside of the strike zone.”
    Still, Lee said he thinks the time is right.
    ‘‘There are reasonable people who will never think it’s ready to go because it will never be perfect,” he said. ‘‘It will be a work in progress forever, but we have to engage in the work.”