Medicare Sites Don’t Offer Adequate Cost, Quality Data, GAO Says

November 18, 2014 in News

Federal websites intended to help Medicare beneficiaries do not provide adequate information about care quality and out-of-pocket costs, according to a Government Accountability Office report, AP/U-T San Diego reports.

Report Details

The report compared information available on CMS sites with similar information on third-party-run sites. The authors also reviewed documents, interviewed government and company officials, and consulted experts about best practices.

Report Findings

The report found “critical weaknesses” on five CMS-run consumer-information sites aimed at informing beneficiaries about the performance of Medicare providers such as physicians, hospitals and nursing homes. The authors noted that the sites make it nearly impossible for beneficiaries to obtain necessary information. The authors attributed this to:

  • Confusing layouts;
  • Data gaps; and
  • The absence of customized information.

In addition, the report found:

  • Charges for the same procedure varied within a geographic region, even when quality remained constant; and
  • Sites frequently lacked quality of care data.

The report noted that rising health care costs bring about an increasing need for patients to have access to cost and quality of care information.

However, the authors found that the government lacks clear policies and performance measures to provide “relevant and understandable information on cost and quality to consumers.” They also noted that, as a result, they do not expect CMS to make changes that will repair the system soon, despite federal plans to build new sites regarding hospice, inpatient rehabilitation and long-term care quality.

GAO noted that providers’ resistance could also limit information sharing.

Reaction

Assistant HHS Secretary Jim Esquea concurred with the report’s recommendations and said CMS intends to expand its star rating system that it currently uses on its Nursing Home Compare site. Esquea also said that HHS has created internal policies to help estimate out-of-pocket cost information “to the extent feasible.” However, GAO did not find evidence supporting that claim, according to AP/U-T San Diego (Yen, AP/U-T San Diego, 11/18).

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