HB 197: Hospital Transparency

1
HB 197 Hospital Transparency

• A Welcome Addition to Hospital Quality and
  Pricing Information for Consumers

2
Existing Initiatives

• Even before the introduction of HB 197, Ohio
  consumers could access a number of Web-based
  resources to help them make informed decisions

3
Websites with quality information by specific
hospital

• HealthPages www.thehealthpages.com
• Hospital Compare www.hospitalcompare.hhs.gov
• Joint Commission on Accreditation of Healthcare
  Organizations (JCAHO) www.qualitycheck.org
• LeapFrog www.leapfroggroup.org 
• MyHealthcareAdvisor.com
• Select Quality Care Consumer www.selectqualityca
  re.com

4
Hospital Rating based on different quality
measures. 

• www.healthgrades.com

5
Search by specific conditions, diseases or
procedures. 

• U.S. News and World Report - America's Best
  Hospitals
• www.usnews.com/usnews/health/best-hospitals/tophos
  p.htm 
• Solucient's 100 Top Hospitals
• www.100tophospitals.com/studies 
• Checkbook's Guide to Top Hospitals
• www.aarpmagazine.org/health/Articles/a2003-01-17-t
  ophospitalschart.html

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Hospital charges for specific conditions and
procedures.  

• Ohio Department of Health
• www.ohanet.org/research/DRG/2005/ 
• Hospital Charges and Utilization, Ohio Department
  of Health
• http//pubapps.odh.ohio.gov/pwh/publicwarehouse.as
  px 
• Health Care Consumer Initiatives
• www.cms.hhs.gov/HealthCareConInit/01_Overview.asp

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Where to find those resources
8
HB 197 Getting to Support

• OHA Strategic Initiative ACCOUNTABILITY
• Public reporting of data is reliable, probative,
  timely, of value to consumers and public policy
  makers, and can be provided in a cost-effective
  manner.
• As approved Jan 2005 by the OHA Board.

9
HB 197 Getting to Support

• Principles of Public Reporting
• Purchasers and consumers of health care should be
  informed.
• Public reporting systems should have the
  confidence of the users.
• A competitive market encourages the continual
  improvement of public reporting systems.
• Public reporting systems should produce reliable
  information, not raw data.
• The costs should not exceed the benefits.
• Adopted by OHA Board, March 18, 2005

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The Original Proposal

• Required hospitals to submit all inpatient and
  outpatient claims data to ODH
• Post outcomes information on a public Web site.
• Sell raw data to outside entities to publish
  their own report cards
• Result 700 million lines of data at a hospital
  cost of 10 million per year for hospitals and 2
  million per year for ODH

11
Enacted Legislation

• Health Director will choose indicators from a
  limited list of nationally recognized measures.
• CMS (existing) -- JCAHO (existing)
• ARHQ (new) -- Limited NQF (new)
• Must consider financial implications on hospitals
  when determining measures

12
Enacted Legislation

• Deletes previous hospital reporting
• S.B. 50 quality reports
• Expands reporting of average charges, volume to
  outpatient procedures

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Timeline

• August 9 Governor Signs Legislation
• Bill Takes Effect 90 days later (early November)
• Early November Hospitals must post on their
  internet sites a price information sheet listing
  room and board charges, charges for x-ray and lab
  procedures, ER and delivery room services, etc.
• Hospitals have been required to provide this list
  upon patient request since late 1980s.

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Timeline

• September 2006 Rules publicly available
• November, December 2006 Hearings
• Early February Rules Effective
• February/March New Director of Health

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Timeline

• April 2007 Hospitals must submit quality
  indicators chosen by the director via rule
• May 2007 Hospitals must submit average charges,
  volume for their top 60 outpatient procedures.
• Expands current inpatient charges, volume
  reporting requirements

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Next Steps

• 2007 2008 -- Advisory Council
• Created in bill to advise director on additional
  measures.
• Council may only recommend measures from those
  developed by 4 national entities (CMS, JCAHO,
  AHRQ, NQF)
• Legislature unsure how to tackle infection
  reporting
• Media attention to C. Diff.
• Nation efforts by Consumers Union
• OHA convening group of Infection Control
  Practitioners, physicians, nurses and others to
  advise OHA on future efforts surrounding
  infection reporting.