AMA Adopts Policies to Improve Data and Price Transparency

New policies promote quality enhancements and support innovative new delivery models

CHICAGO - June 9, 2015 - As part of its ongoing efforts to ensure greater health care transparency that can improve health outcomes, increase the value of health care spending and strengthen physician-patient relationships, the American Medical Association (AMA) at its annual meeting today passed two new policies that address the growing interest in health care data and price transparency.

Over the past few years, large amounts of health care information have increasingly become publically accessible through the Centers for Medicare and Medicaid Services (CMS) and other sources, such as all-payer claims databases, registries and qualified entities (QEs).  While more health information is available to the public, much of the released data is not timely or actionable and lacks context.  The two new AMA policies aim to address these limitations and ensure physicians, practices, care systems, physician-led organizations and other relevant stakeholders can proactively access meaningful health care information that will help physicians improve the quality reporting of patient care data, foster more medical innovation and enable new delivery and payment models. In addition, they support efforts to improve the health literacy of patients so they can understand the health care pricing information that they may access.

“Transparency of both cost and quality is needed for patients, physicians, public and private insurers and other stakeholders throughout the health care system to make more informed health care decisions,” said AMA President Robert M. Wah, MD. “The policies adopted today will help facilitate price and quality transparency for patients and physicians and to put into place much needed safeguards that ensure the accuracy and relevance of information provided.”

The new policies also encourage physicians to communicate information about the cost of their professional services to individual patients, taking into account insurance status and other information where possible. Additionally, they call for collaboration with health plans, public and private entities, and other stakeholder groups in their efforts to facilitate price and quality transparency for patients and physicians.

“Successful implementation of any price transparency program requires cooperation and collaboration by all stakeholders, including physicians,” said Dr. Wah. “However, it is very important that transparency initiatives be prioritized to engage and inform physicians in a timely manner to help improve care quality.”

One of the new policies contained a new set of AMA principles that highlight the resources physicians need to make ongoing transparency efforts beneficial.

The principles include a number of provisions such as:

  • Greater physician engagement in transparency efforts, including the development of physician-led quality measures to ensure that gaps in measures are minimized and that analyses reflect the knowledge and expertise of physicians;
  • Greater access to current information that can inform choices at the point of care;
  • Removing barriers to accessing information from private payers and other care settings, focusing on data that is valid, reliable and complete; and
  • Development of user interfaces and analytics that allow physicians or their staff to structure simple queries to obtain and track actionable reports related to specific patients, peer comparisons, provider-level resource use, practice patterns and other relevant information.

The new policies expound on the AMA’s continued efforts to improve the quality of patient care and support innovative delivery models. The AMA has been actively working with the administration to improve upon its data releases to make sure publically available information is accurate, timely and actionable. Additionally, the AMA has been advocating for policymakers to provide physicians more timely and actionable information regarding resources and quality measurement. For more information about AMA efforts around transparency, please click here.

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