A recent Deseret News editorial (April 20), "Tell Utahns how much they pay the hospitals," made a plea for a health cost data program. The editorial implies that having more comparative data through a mandated data council is the remedy to solve Utah's health-care costs problem.
The Utah Hospital Association (UHA), representing 42 member hospitals, wishes to present another perspective.UHA conducted research with 14 of 30 mandated states. The findings are clear that data councils are costly and thus far ineffective in curtailing rising costs.
Governmental costs to maintain such councils, provider costs to supply the data and development of a severity of illness system (necessitated by a mandated council), drive costs higher - consumers of health-care services would absorb these costs.
The research also shows that comparative charge data did not curtail rising costs in any of the 14 states.
The Federation of American Health Systems (FAHS) found that from 1984 to 1987, per capita hospital expenditures rose 6.5 percent a year in six regulated states, compared with 5.1 percent in non-regulated states, indicating that artificial efforts to contain costs have not worked as well as allowing hospitals an opportunity to adjust in a competitive market.
Is it time for Utah to become more regulated? Legislators soundly defeated legislation introduced in 1988 to establish a mandated data system. The lawmakers recognized that costly legislation is not the remedy.
UHA has implemented a voluntary and much less costly data program. After thorough study, UHA released 1988 charge data for the top 36 DRGs (diagnosis related groups). UHA plans to publish like reports every six months. The next report (August release) will represent 30+ hospitals (90 percent of Wasatch Front discharges).
The editorial rejects UHA's first report because data were not included on outpatient care, physician charges, long-term care, HMOs and insurance premiums.
Utah's hospitals are providing exemplary leadership in voluntarily providing comparative charge data. Other providers and insurers have not followed suit.
The report was further challenged because "the information is difficult to interpret."
The report was designed to avoid the pitfall of reporting only "average charges." Utah's data were presented in percentile format because the median (50th percentile) more accurately reflects the actual procedure charge than does the average, subject to skewed distortions created by extreme cases.
Clearly, hospital care providers realize that it's hard for patients to shop comparatively without information. They are voluntarily providing comparative charge data.
However, UHA believes that the solution to the costs issue is much broader than just providing comparative charge information.
Costs have risen as we respond to the demands of a public who expect high-quality services, new expensive health-care technologies, access to services and skilled labor to run it all.
Additionally, nearly one-third of the yearly increases in costs are due to hidden costs for the 37 million poor and uninsured Americans who seek service from our hospitals.
Costs for service to these individuals are not being adequately reimbursed by Medicare, further aggravating the problem.
UHA has demonstrated its willingness to work with those who seek to solve the state's rising costs problem. Hospitals are voluntarily submitting data.
We are hopeful that other providers and insurers will submit like data in an all-out effort to understand and thereby control rising health-care costs.