Part of the Affordable Care Act requires that CMS make publicly available standardized claims data extracts that can be used to evaluate the performance of physicians, hospitals and other providers.  This proposed rule is currently available for public comment.

Philosophically, we are in favor of making as much information available as possible.  We trust the diffused market far more than centralized control structures to make the right decisions over time, and good information is the fuel for consumers and the market to work. 

There are two elements behind our support of this idea.

• Transparency:  The more transparency, the better the market can operate.  Think about what happened in the 401(k) world when funds had to fully disclose things like their fee schedule and expense ratios.  Investors could make better decisions about where to invest based on their own personal situation.  The more of this we give to patients, the better.  And transparency is always good for the good guys.  Good umpires like instant replay because it shows they are right almost all of the time.  Good quality data will be good for good physicians because right now they are all lumped together in an indistinguishable pile.
• Value Add: Once we start publishing large chunks of data, enterprising entrepreneurs will figure out how to use it to create new value.  Think about all of the information on your PC or phone that comes to you now because the government decided to publish the data from its weather satellites.  Big data, free data, fast data will drive a lot of valuable services for the people who need it.  Again, we trust the market to figure this out more than the government.  Give us the data and get out of the way.

But as we wade into these new waters, a couple of cautions must be addressed.

In the 401(k) world, there are only a few data elements from each fund and they are well defined and generally very standardized.  That is why that works.  The expense ratio for an international small cap growth fund means the same thing as the expense ratio for a government bond fund.  We are a long way from that level of standardization in healthcare and need to work quickly to get there if this public data is to be valuable.

While we have rightly had a lot of discussions of late about protecting the privacy of patient data, we have not talked much about protecting the accuracy of physician data.  If this information is to be used to evaluate physicians and other providers, it better be accurate.  This is not like telling someone the temperature in Boise will be 85 today when it really will only be 72.  This information could cause a physician practice to prosper or fail.  It has to be right.