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Making Health Care “Value” Work for Consumers

The latest health policy buzzword is “value,” which means better care/ better health at lower costs. That’s also a growing battleground for consumer advocates.

Consumers have long known that health care costs too much – out of pocket spending keeps growing, it cuts into paychecks, diverts public funds from other important needs. And those of us who have gotten bad care – duplicate test, preventable infection, no help in treating a chronic condition, etc. – know we could be doing better.

We’re also not getting enough bang for our buck, especially in Ohio. We rank 47th on a composite measure, combining costs and population health. We’re 49th on Medicare spending, 47th on infant mortality, 46th on adults with diabetes, to name a few. Our dramatic racial, ethnic and poverty disparities drag our quality scores down even further – an African-American child born today in Ohio can expect to live more than a decade less than children in other racial/ethnic groups.

That’s why we need both better care and lower costs – that is, better value. But to succeed on the value battleground, consumer advocates need to understand the real reasons for high costs and poor quality and propose policy solutions to fix what’s broken.

Payers (insurers and employers, including state and local governments) and providers are actively negotiating to improve value. But they all have their own interests to protect. The users of health care, who have interests that are often distinct from providers and payers – have not been active, ongoing participants in these negotiations over the future of our health care.

UHCAN Ohio and Ohio Consumers for Health Coverage have given important input over the years, but we have to grow the consumer voice, if we are to influence the negotiations significantly.

Sorting out the real drivers of high costs and poor quality gets complicated quickly. Often, the real facts challenge common assumptions about cost drivers. Which is a greater driver of health care inflation, volume of services or unit price of health care services? The experts agree it’s the latter – unit prices.

To help consumer advocates around the nation, Consumers Union has launched a new “Health Care Value Hub.” Funded by Robert Wood Johnson Foundation, the Hub provides advocates with a wealth of reliable information and analysis on drivers of cost and quality, as well as tools for targeting efforts toward different sectors and identifying effective strategies.

The Hub is a result of several years’ work with many national experts at debunking myths and understanding major and minor contributors to high health care costs and poor quality (UHCAN Ohio’s executive director participated in the development process). For “value” geeks, this Hub is like a giant toy store would be for any self-respecting kid. Information on the Hub will certainly guide UHCAN Ohio’s advocacy efforts in the future.

Stay tuned!