A few weeks ago, TIME magazine named Pope Francis as its "Person of the Year" for 2013. It's difficult to encapsulate an entire year with one person, but TIME's decision is one backed by some valid points.
For the first time in several hundred years, a new pope was named while the former pope watched. And Pope Francis has shown charisma, humility, personality, humor and kindness that has transcended faiths.
That got us thinking: Who, in healthcare, our daily beat, made the biggest difference in 2013?
There are the obvious candidates: President Barack Obama, HHS Secretary Kathleen Sebelius, CMS Administrator Marilyn Tavenner — although an argument could be made they would rather forget 2013, given the headaches and problems that plagued the HealthCare.gov rollout.
After batting around a couple nominees, if you will, we decided the most influential person to leave a footprint on healthcare this year is not actually a leader, official or executive by title. He is a journalist: Steven Brill.
In March, Brill threw the healthcare industry into a state of frenzy with his explosive TIME exposé, "Bitter Pill: Why Medical Bills Are Killing Us." The 36-page investigative report — the longest story TIME has published by a single author — delved into the high costs of healthcare, the role of chargemasters and how providers can profit off the lack of transparency throughout the system. To write the story, Brill dug through pages and pages of hospital bills, codes and raw charge data. By the time he was finished, he had three file cabinets full of data.
It made ripples throughout the country: Hospital lobbyists rushed to defend their practices, consumers were intrigued and policymakers became engaged. Brill told the Columbia Journalism Review that he saw a "muted" response from hospitals, but the public's reaction to the article was like nothing he has seen to an article he's written. "People are
really interested in this," he said. "I get 30 emails a day from the public."
Brill's article sounded the alarm for the recent healthcare price transparency movement. Several healthcare advocacy groups released healthcare transparency reports for states and providers. One report card from the Catalyst for Payment Reform and the Health Care Incentives Improvement Institute found 29 states earned an "F" grade for providing adequate information about healthcare prices to consumers.
It was a noteworthy event when, in May and June, CMS released troves of data on the 100 most frequently billed inpatient charges and 30 most common outpatient charges, finding large variation in hospital prices from market to market. (This information was previously available, but for consumers, not without some digging and an idea on where to find it.) The updated numbers led some states, like North Carolina and Arizona, to enact laws requiring hospitals to post chargemaster prices of their most common procedures. This past month, the New York State Health Department also posted hospital chargemaster and cost data for 1,400 conditions and procedures from the past few years on its website.
While these measures do improve transparency, many hospitals and experts argue that chargemaster data rarely reflects the true costs to a payer or patient, further complicating matters. Comparing hospital prices may not be apples-to-apples, they say, and raw data from CMS may not exactly help consumers make decisions about where to go for procedures. But when making our decision to name Brill our person of the year, we based it on this thought: The fact that the government swiftly made the data public after publication of the article was an important moment in the shift toward improving the public's understanding of hospital prices.
Some hospital leaders began to see price transparency as one way to distinguish their institutions in an opaque industry. During an interview with a local radio station in May, Steve Sonenreich, president and CEO of Mount Sinai Medical Center in Miami Beach, Fla., made a pledge to post the contractual rates the hospital pays private payors for diagnoses and treatments. He also challenged other hospitals in the area to do the same.
While President Obama and many other healthcare leaders carried out big provisions of healthcare reform, Brill stopped and asked if we are reforming the right things. And as reporters and editors ourselves, we can't ignore the spark Brill lit for other journalists writing for local and national publications. This is no accident. It's exactly what Brill intended to do.
In a blog post for TIME, Brill suggested that reporters "in every American city and town" use CMS' data as a tip sheet and ask their local hospitals to explain their pricing. "A story like the one I wrote can and should be written in every community in the U.S.," he told the Columbia Journalism Review.
Consumers are shouldering more of their own healthcare costs than ever, forcing them to look at prices in healthcare like those in a retail store. For a long time, the largest question on consumers' minds seemed to be: Who should pay my medical bills? Brill's piece, and the price information that was made available in the months after its publication, shifted the public's focus to a larger question: Why are these prices so high? Many of the first, important steps to getting some answers occurred in 2013. It has been fascinating to watch the price transparency movement unfold in various arenas of the healthcare industry, and we have a feeling this pace won't slow too much in 2014.