WASHINGTON – Customers shop around when they buy an airline ticket or a new car, so why not when they need a hip replacement or treatment for a sore throat?
An executive order being signed Tuesday by President Bush is designed to help people make more informed decisions about doctors and hospitals.
Four federal agencies will be required to compile information about the quality and price of care they pay for and share that information with their customers and each other.
"We're all about being cost-conscious," said Health and Human Services Secretary Mike Leavitt. "It's just the American way. We clip coupons. We check for bargain flights on the Web. We carefully research major purchases. But when it comes to health care, we lack the tools to compare either quality or the costs."
Bush will sign the executive order in Minnesota, where he will talk with health care providers about "health transparency." Afterward, he will attend a campaign fundraiser.
The order directs the agencies to:
—Use, where available, health information computer systems that can talk to each other. That way, the health records of a veteran living in Maine can be viewed by a doctor working in California if the veteran needs emergency care there during a vacation. Agencies will also require that providers doing business with the government purchase products that meet that same standard for data sharing.
—Enact programs that measure the quality of care, and develop those measures with the private sector and other government agencies.
—Make available to beneficiaries the prices that agencies pay for common procedures.
—Develop and identify practices that promote high-quality health care.
The agencies affected by the executive order are the Health and Human Services Department, which oversees Medicare; the Defense Department, which oversees health care for the military; the Veterans Affairs Department and the Office of Personnel Management, which oversees the Federal Employees Health Benefit Program. A draft of the order says agencies must comply by Jan. 1, but Leavitt said the programs must be under way by that point, rather than completed.
Leavitt said the federal government's role is critical because it pays for nearly 40 percent of health care. That's a lot of data that insurers and other health care providers can use to educate consumers, he said.
"It will fuel a substantial amount of change in the way health care is ultimately purchased, but it will take time for that to unfold," Leavitt said.
While consumers frequently go to great lengths to research major purchases, that's not the case with health care, said Karen Davis, president of the Commonwealth Fund. Surveys indicate that only about 15 percent of patients look up information on quality or pricing, she said.
"I think it's very important to try to have this information in the public domain," Davis said. "It's not so much patients that will act on it, but hospitals, doctors and nursing homes get motivated to improve when they see how they compare with their peers." The Commonwealth Fund provides grants for health care research.
Dr. John Tooker said physicians also support more transparency because it will help them do a better job. But there is concern that health care providers should be given a chance to review the information before it's distributed to the public.
"The information provided to patients needs to be reliable," said Tooker, CEO and executive vice president of the American College of Physicians.