Commitment to Health Care Transparency

 

PruittHealth supports building a transparent value-driven health care system to improve quality of care and reduce unnecessary spending. PruittHealth believes that transparency initiatives should provide consumers with tools to make informed decisions about their health care, with respect to both cost and quality. We believe that transparency initiatives should reflect the four cornerstones of value-driven health care outlined by the federal Department of Health and Human Services, (HHS).  In an effort to make that support known to the public we serve, we have signed the HHS "Statement of Support" to encourage the health insurance plans, third party administrators, providers, and others with which we contract to take consistent actions to achieve the following "Cornerstone" goals.

Support for the Four Cornerstones of Value-driven Health Care

America's health care system has an unprecedented opportunity to lay new foundations for better patient care, higher quality service, and increased value.

To help realize this opportunity, we commit to support the following actions and will encourage the health insurance plans, third party administrators, providers, and others with which we contract to take consistent actions to achieve these goals.

Support Health Information Technology

In order to enable the availability and secure exchange of healthcare information to improve patient care, we will support interoperable health information systems and products. When those with which we contract implement, acquire, or upgrade health information technology systems and products, we will request that they use systems and products that meet interoperability standards recognized by the Secretary of Health and Human Services. In maintaining or exchanging information, patient privacy will be appropriately protected, as required by law.

Provide Quality Information

To support knowledge and comparison of the quality of care delivered by health care providers, we will implement, or request that those with which we contract implement programs to measure health care provider quality and make this information available to enrollees in the health plans we sponsor. At the present time, the measures most fully developed are those endorsed by the National Quality Forum (NQF) and adopted by AQA (a multi-stakeholder group focused on physician quality measures) or the Hospital Quality Alliance (HQA). We anticipate that quality measurement and reporting programs will be based on these measures. However, if we wish to measure quality of care in other areas, we will use measures endorsed by the NQF or, alternatively, approved by other national broad-based organizations, and we will support national consensus efforts to increase the availability of consistent quality measures in these areas.

Provide Pricing Information

To support knowledge and comparison of the cost or price of care, we will implement, or request that those with which we contract implement, programs to make available to enrollees in the health plans we sponsor the overall cost or price of their care. As consensus develops on uniform approaches for measuring and reporting cost or price information for the benefit of consumers, we will use these approaches and request that those with which we contract do the same. We will promote the availability of cost or price information together with quality information, whenever possible, to help our enrollees focus on value. We also will request that those with which we contract participate in broad-based national public-private collaborative efforts to develop appropriate strategies to measure the overall cost of services for common episodes of care and the treatment of common chronic diseases, while avoiding undue administrative burden on health care providers.

Promote Quality and Efficiency of Care

We will work to develop approaches that encourage and facilitate high-quality and cost-effective health care, and contract with entities that help us to achieve these goals. Such approaches may include, for example, implementation of pay-for-performance methods of reimbursement for providers, the offering of consumer-directed health plan products, such as account-based plans for enrollees in employer-sponsored health benefit plans, or the use of high performance provider networks.

We recognize that this initiative is part of an ongoing effort to share quality and cost or price information. Over time, this information can be used to improve patient care and enhance the effectiveness of our health care system by increasing the availability of uniform and comparable information with which all stakeholders can make informed decisions. These steps are the foundation for a value-driven health care system that delivers continued progress in medical care and good health for all Americans.

You may obtain information about PruittHealth's Commitment to Health Care Transparency by calling (770) 279-6200 or (706) 886-8493.