New medical data allows comparison shopping

“Whenever you put information out there, creativity and innovation flourish,” she said. “This is going to be such a giant leap forward in terms of what we’re doing in health care today, what works, what doesn’t work and what it should cost.” But for that to happen “there needs to be some “pretty powerful computing and some savvy tech gurus to help slice and dice this information in meaningful ways for consumers”

New York is sponsoring a contest — the Health Innovation Challenge — that asks the tech-savvy, including coders and developers, to put health data to use keeping costs down, increasing quality and improving efficiency. Winners receive cash, and their ideas will be put to work in the state government.

Shah said releasing the data — and allowing researchers, entrepreneurs and consumers to dig into it — could “democratize” health care in a way that has already happened with the way people buy cars or plane tickets: It will allow them to compare cost and quality.

Instead of making decisions based on quality, people tend to pick their providers based on where their doctor recommends they should go, and that might mean where she did her residency or a specialist whom she plays golf with, he said. New data may allow people to comparison shop for medical care.

While Shah acknowledged a “special” relationship between a patient and a doctor that includes treatment plans and communication in ways that won’t be picked up in data, a colonoscopy should be the same everywhere.

 Rather than taking doctors’ recommendations, entrepreneurs will take data, repackage it and show people which hospitals have the longest average stays, which charge the most for a procedure, and which have the highest infection rates.

“Often, we find that high quality equals lower costs,” he said. That’s because the most cost-effective procedures tend to be the ones where patients receive proper medications, do not have to be treated for hospital-based infections, and where providers work as a team to make sure quality measures are met.

As more people — or their employers — choose low-premium, high-deductible plans, the cost of a knee surgery or an imaging scan becomes more important to the consumer than when insurance covered everything.

http://www.usatoday.com/story/news/nation/2014/04/16/new-cms-data-inspires-entrepreneurs/7735469/

New medical data could allow comparison shopping

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WASHINGTON — As the government moves toward more medical “transparency” by releasing a slew of new data— including Medicare provider payment data last week — entrepreneurs are creating new products to help consumers use the data to choose quality, lower-cost care.

Beyond the profit motive, some entrepreneurs hope to use the data to keep costs down on new medical products they create, help the government suss out fraud or unusual activity, and to persuade doctors to use the best practices gathered from their peers — something that was difficult to do when pricing information was not available.

CHART: See how much Medicare paid each doctor in U.S.

“I think this data transparency is one of the major keys to transformation of the entire health care system,” said Robert Grajewski, president of Edison Nation Medical, a group that works to remove barriers for getting medical devices to the market. “In health care, it’s very confusing to know what the pricing is, not just for the device, but for the overall procedure. This helps us have a benchmark that needs to be achieved or overcome to improve care and overcome costs.”

The provider payment data released by the Centers for Medicare & Medicaid Services has Grajewski looking at why prices are higher for one doctor over another, why a doctor might choose a brand name over a generic medication, and why a doctor might choose surgery over physical therapy. The data became available after a court order lifted an injunction sought by the American Medical Association had been in place since 1979.

Grajewski isn’t the only one. Mercom Capital Group released a report Monday that found venture capital funding for health care information technology hit $858 million in the first quarter of this year. That includes $398 million in 103 new deals for consumer-focused technology, such as mobile apps.

“We’ve been tracking these numbers since 2010, and this quarter was the biggest number ever,” said Raj Prabhu, Mercom’s CEO. “$858 million is a huge number — in 2010, I don’t think we saw $200 million.”

Much of the momentum is coming from inventors who hope to create shopping applications that allow consumers to compare prices and outcomes on their smart devices. These include apps such as GoodRX, which allows consumers to compare medication prices at different pharmacies; NerdWallet Health, which allows people to compare hospital prices by locations; and an app from Consumer Reports that lets people compare prices for hip and knee replacements.

“Ever since the government started releasing data, this has been great for these kinds of companies to turn into useful applications,” Prabhu said.

“Every person is a health care consumer,” he said. “It’s so massive — nobody wants to miss the boat.”

Ceci Connolly, managing director of PWC’s Health Research Institute, said she expects the data to ultimately help the health care industry itself.

“Whenever you put information out there, creativity and innovation flourish,” she said. “This is going to be such a giant leap forward in terms of what we’re doing in health care today, what works, what doesn’t work and what it should cost.”

But for that to happen, there needs to be some “pretty powerful computing and some savvy tech gurus to help slice and dice this information in meaningful ways for consumers,” she said. Someone could use the CMS data to look at trends in hip surgeries: Is it much higher for one hospital than at others? A consumer might reconsider whether he actually needs surgery from a particular doctor. Or are there relatively few hip surgeries at the local hospital? The consumer might consider going to a doctor who performs a lot of hip surgeries.

Someone else might take the CMS data and compare it to CMS’s Five-Star Quality Rating System data, Connolly said.

“The whole promise of big data is not just any one data set, but it’s the way you can bring them together and analyze them across many,” she said.

New York is sponsoring a contest — the Health Innovation Challenge — that asks the tech-savvy, including coders and developers, to put health data to use keeping costs down, increasing quality and improving efficiency. Winners receive cash, and their ideas will be put to work in the state government.

It comes after the launch of the state’s transparency project, Open.NY.gov, which features data that state agencies have been ordered to catalog for the public.

“For a long time, the medical establishment has talked about patient-centered care,” New York State Department of Health Commissioner Nirav R. Shah. “But largely, it’s still been about hospital-centered care, doctor-centered care.”

Shah said releasing the data — and allowing researchers, entrepreneurs and consumers to dig into it — could “democratize” health care in a way that has already happened with the way people buy cars or plane tickets: It will allow them to compare cost and quality.

Instead of making decisions based on quality, people tend to pick their providers based on where their doctor recommends they should go, and that might mean where she did her residency or a specialist whom she plays golf with, he said. New data may allow people to comparison shop for medical care.

While Shah acknowledged a “special” relationship between a patient and a doctor that includes treatment plans and communication in ways that won’t be picked up in data, a colonoscopy should be the same everywhere.

Rather than taking doctors’ recommendations, entrepreneurs will take data, repackage it and show people which hospitals have the longest average stays, which charge the most for a procedure, and which have the highest infection rates.

“Often, we find that high quality equals lower costs,” he said. That’s because the most cost-effective procedures tend to be the ones where patients receive proper medications, do not have to be treated for hospital-based infections, and where providers work as a team to make sure quality measures are met.

As more people — or their employers — choose low-premium, high-deductible plans, the cost of a knee surgery or an imaging scan becomes more important to the consumer than when insurance covered everything.