Data and Policy

The right data at the right time are needed to stimulate change within a market. Data are necessary to create consensus on what type of payment reform work is appropriate for the market. Timely availability to data can ensure a quality improvement component that is imperative to produce adequate payment or shared savings for markets and thus continue to engage stakeholders. It is difficult, if not impossible, to maintain momentum on payment reform efforts without data to evaluate progress, both short and long term. Stakeholders must be willing to share data in a timely manner and deliver them in a common, useable format for analysis. Timely data should include enough detail to support patient care and quality improvement interventions. This will allow markets to identify opportunities and disparities in care and drive improved outcomes.

State government involvement can negate concerns of some stakeholders on legal issues around payment reform efforts. Legislation to compel health plans to provide cost data and for that data to be publicly reported has precipitated advancement in payment reforms in several markets. For example, the Washington Alliance partnered with the state to safeguard members of the workgroup from anti-trust issues. Additionally, starting in 2016, health plans in Washington will be required to provide members with transparency tools armed with specific price and quality information. The new legislation, passed in March 2014, will afford health plan members the opportunity to make more informed health care decisions based on cost, quality, and patient experience.

In addition, Alliances have found a strong link between cost transparency and payment reform efforts. Understanding the true costs of health care can facilitate conversations about why payment methods must change.