Vermont's auditor urges more health care consumer info so residents can assess prices, quality

Vermont's state auditor is asking lawmakers to beef up the information consumers can get when deciding where to have a medical procedure done.

Auditor of Accounts Doug Hoffer, joined by Andrew Stein, a special investigator in the auditor's office, told the House Health Care Committee on Friday that the state is falling short in meeting a legal requirement to provide information so consumers can compare prices and quality indicators of health care providers.

Hoffer and Stein said Vermont collects information that could form the backbone of a consumer-friendly website in a database called the Vermont Health Care Uniform Reporting and Evaluation System.

A website geared to consumer access would allow people to enter information including, "This is where I live. This is the kind of (insurance) coverage I have. I'm willing to drive within 75 miles. Tell me what all the providers charge for this particular service," Hoffer said.

The database is overseen by the state's Green Mountain Care Board, a five-member panel responsible for overseeing several projects aimed at lowering costs and improving access to health care. Board Chairman Al Gobeille did not immediately respond to a message left at his office.

The committee took no immediate action on Hoffer's proposal on Friday.

State Rep. George Till, an obstetrician-gynecologist at the University of Vermont Medical Center, said he understands the appeal of the idea being pushed by Hoffer. But he urged caution.

"You've got to make sure you're doing an apples-to-apples comparison," said Till, a Jericho Democrat and former member of the Health Care Committee. Till said he had heard a similar presentation earlier in the week from Hoffer to the Ways and Means Committee, of which Till is now a member.

Comparing academic medical centers like UVM and the Dartmouth-Hitchcock Medical Center with Vermont's smaller community hospitals "is going to make the academic medical centers look not so good," Till said.

That applies both on the cost and quality fronts, both often a result of the fact that the smaller hospitals send their tough cases to the highly trained specialists at UVM and Dartmouth, Till said.

"What are my outcomes compared to a place that doesn't deal with any complicated cases?" Till asked. "That's the messiness of the whole quality and cost comparison."

Hoffer said several recent studies had found in states that provide better consumer information that costs tend to be reduced. And he said costs can vary widely. One California study found knee-replacement surgery cost as much as $20,000 more in some parts of the state than others, Hoffer said.