You might think that if you pay the premium for the fancy downtown hospitals (under Partners HealthCare) that you'd be getting the tip-top quality you and your insurer are paying for. You'd be wrong about that. Finally, in a major report out today, the Globe got its paws on some of the hospital quality data that the hospitals have been keeping all to themselves.
Call it the best-kept secret in Massachusetts medicine: Health insurance companies pay a handful of hospitals far more for the same work even when there is no evidence that the higher-priced care produces healthier patients. In fact, sometimes the opposite is true: Massachusetts General Hospital, for example, earns 15 percent more than Beth Israel Deaconess Medical Center for treating heart-failure patients even though government figures show that Beth Israel has for years reported lower patient death rates.
Private insurance data obtained by the Globe's Spotlight Team show that the Brigham, Mass. General, Children's Hospital, and a few others are, on average, paid about 15 percent to 60 percent more than their rivals by insurance companies such as Blue Cross Blue Shield of Massachusetts and Harvard Pilgrim Health Care. The gap is even more striking for many individual procedures, which can be two or three times more expensive in one hospital than in another.
It should drive everyone absolutely nuts that a.) there are confidentiality agreements regarding payment; and b.) that the hospitals don't willingly disclose their own quality data as a sign of good faith.
I remember over a year ago hearing MGH CEO Gregg Meyer explain away the hospital's resistance to publicizing a particular quality indicator (HSMR) by saying essentially that the public might misinterpret such data.
I'm more irritated about that now than I was a year ago. That is an utterly bogus excuse — completely self-serving, and manifestly to the detriment to quality care, our wallets, and indeed to his hospital's reputation. Health care is indeed a marketplace. A marketplace without information is not a market at all — it's a shakedown.
And they're still trying to keep the rest of the quality data under wraps — in contradiction to the express intent of the Chapter 58 legislation:
The law calls for the council to post insurance claim information on the web so that the public can see the disparities. But a year and a half after the law was passed, the council has still not published its findings because of disputes with medical groups about how the numbers should be presented and whether they are accurate in every detail.
Outrageous. They don't want to have to earn their sterling reputations — they just want us to pay through the nose for it.
The game is up; the reputations are sullied; everything is suspect. We already knew this was true, after all. If the hospitals don't come clean themselves — now — the legislature should be prepared to:
- Outlaw confidentiality agreements regarding cost of services.
- Publish the quality data currently under wraps, pronto.
- Strongly consider smashing the cartel of Partners: MGH + BWH.
If we indeed have the best health care in the country right here in MA, it's time for the providers to earn that status. Free the data!