Measurement Is Coming

Let’s say you need an MRI of your lower back (and so we’re heeding the Choosing Wisely recommendations from the American College of Physicians, we’ll say it’s for some specific suspected abnormality and not just non-specific back pain). How much is that going to cost? Well, if you’re in Richmond, Va., the average cost approaches $2,600, while about 150 miles south in Raleigh, N.C., the average cost is less than $1,000.

These numbers on price variation come from San Francisco-based Castlight, a company aimed at helping employers with benefits management, and one of the ways it does this is by arming consumers with data and improving price transparency. You can read more about their efforts detailing price variation in metro areas across the U.S. on this issue’s “Meaningful Measures” page at the back of the book.

What to make of these data? Certainly being equipped with this knowledge could make consumers—both employers offering a benefit plan and the insured population actually seeking imaging services—more aware of the true cost of healthcare. This transparency may in turn lead to lower costs.

But broader than the specific findings in this analysis, the Castlight report is another indication that “big data” has arrived and is making an impact right now. The implications of big data were a major focus at this year’s annual meeting of the Society for Imaging Informatics in Medicine (SIIM) and Health Imaging reports on the current discussion around big data in this month’s cover story.

I’m also reminded of the release of Medicare physician payment data earlier this year, which tabbed $77 billion in payments made to 880,000 physicians and other providers in 2012. We reached out to a professor of public policy at the Harvard Kennedy School to get his take on the Medicare payment data. See his recommendations here.

That data release was a fairly blunt instrument that didn’t account for overhead costs or specific billing arrangements at various practices, but it serves as a powerful signal. It is clear that robust cost and value measurement is coming and that providers need to get ahead of the game in terms of self-measurement and start thinking about evaluating and proving the value of care they are offering patients.

If providers don’t start this process for themselves now, somebody else will be doing it for them shortly—and they may not be happy with the findings.