Monday, May 20, 2013

Health Care Transparency Requires Open Data

Transparent pricing and quality data is the foundation of the US economy, yet is entirely lacking in our Health Care industry. New players like Castlight have raised over $130 million to provide greater transparency, but only to selected customers who pay for that data.

I believe making health care pricing information freely available (like Wikipedia for health care data) will help reduce these inequities in our health care system. 

Last week's release of Medicare provider charge data from hospitals across the US pointed the way forward - making pricing data publicly available to everyone. Because the government pays in a unique way, this data is only a starting point - what is needed is a public data set showing what employers and individuals pay for these same services.

Several years ago, I had a personal experience that ignited a passion to drive change in US healthcare. While our family was living in Paris, my son was diagnosed with a benign brain tumor. We went through a series of medical procedures in France and then repeated them on our return to San Francisco.

Because our insurance only covered major medical procedures, we had to pay these bills personally. We found that medical costs for in the US averaged a factor of seven to ten times higher than what we had paid in Paris.

A good first step would be to analyze claims data from 3-5 large US employers to create a dataset showing the prices eployers paid for the most common procedures across providers (including the top 100 most frequently billed discharges information published by  Medicare). This analysis would help employers verify the health care prices they are paying.

Making this information available on a publicly available web site could unlock a wave of innovation in the world of health care, much as open source communities have transformed the software world.