Proposed Bill Would Increase Healthcare Cost Transparency

Much has been made of the industry efforts to increase the transparency of healthcare costs, but two Senators say it’s not enough.

U.S. Senators Tammy Baldwin (D-WI) and John Thune (R-SD) introduced legislation this week, the Quality Data, Quality Healthcare Act, which would reform the Qualified Entity (QE) program, an effort that allows organizations to access and analyze comprehensive Medicare data for select purposes. Current laws, the Senators say, are too restrictive on which organizations can participate in the QE program and what can be done with that data.

With this bill, those organizations would receive Medicare data to analyze and redistribute it to authorized subscribers (insurers, health systems, and physicians) so that subscribers can make more informed decisions and organizations can conduct robust analyses to improve healthcare quality and reduce costs. 

“Medicare is the single largest payer of healthcare services in the country, spending over $600 billion each year. But we know very little about what we are paying for,” Senator Baldwin said in a statement. “The Quality Data, Quality Healthcare Act provides access to that data and puts it into the hands of those who can best use it, helping doctors make more informed decisions and improving how we deliver healthcare.”

It’s not the first time Baldwin and Thune have introduced the legislation. In 2013, she tried to introduce a similar bill, which ended up being referred to the Committee on Finance. Over the past few years, the Centers for Medicare and Medicaid Services (CMS) has released Medicare payment data. Baldwin says those efforts “lack the necessary detail and context to be most useful.”