Thanks to President Tedd L. Mitchell, M.D., recommending me, I have the privilege of serving as an “ex-officio” member of the Institute for Healthcare Quality and Efficiency. It is a group established by the state legislature for the purpose of identifying and promoting evidence-based approaches to “improve health care quality, accountability, education, and cost containment in this state.”  The institute is charged to study and issue recommendations in three broad areas:

• Improving the quality and efficiency of health care delivery
• Improving the reporting, organization and transparency of health care information
• Supporting the implementation of innovative health care collaborative payment and delivery systems.

I do enjoy it and some of the leaders of health care profession in Texas sit on the panel (prominent physicians as well as CEOs of major hospital systems, insurance companies, and large clinics, for example.)

Regarding the second bullet above, one of the items we discuss a great deal is making the price of health care services more transparent to the public. As you might imagine, this is an area of controversy.  For example, we spent hours just deciding what to call the price of services.  Is that the charge?  Is it our cost?  Is it the allowable? We finally started calling it the “amount accepted as payment-in-full.”  Now that is not an artful phrase that rolls trippingly off of one’s tongue. For this column, I will use the term price or prices.

Several on the panel have serious reservations about sharing price information on health care services. They say it is too complicated and that it is too hard to estimate what might have to be done for the patient. What they are talking about is incidental surgeries, unplanned diagnostic tests, or unexpected complications that might arise and make the pre-hospital estimate very inaccurate. (An incidental procedure is performed at the same time as a more complex primary procedure and is important and needed —but, it was not the intent going into surgery.) This all sounds bad, but not always —sometimes issues are discovered and repaired that can be addressed on the same visit or hospitalization and save everyone’s time and money. The point is people are not widgets and we just cannot say with 100 percent certainty this is what a patient’s bill will be at the end of the hospitalization or visit.

You are probably aware that prices for medical services vary greatly — even for the same procedure in the same community. This is becoming more important information to have as individuals are being responsible financially for a greater portion of their health care costs.  An example is the high deductible plans that are much discussed.

If individuals are going to become prudent purchasers, they will have to have information on health care prices.

I noted with some interest that three big health insurers announced an online tool giving consumers free access to the price and quality of medical care.

Aetna, Humana and United Healthcare are joining with the Health Care Cost Institute to provide information from their claims data showing what consumers might expect to pay for hundreds of treatments offered in their community.

The online service is scheduled to begin sometime in the first quarter of 2015, and will have data from about 40 percent of commercially insured Texans. BlueCross/BlueShield of Texas, the state’s largest insurer, is not participating yet.

I think we are slowly seeing more price transparency in the health care industry. This is a trend likely to only accelerate in the months and years ahead.