Last month, the White House released a much-anticipated executive order on health care transparency, which “seeks to enhance the ability of patients to choose the health care that is best for them.” At Castlight, we are thrilled to see an equal emphasis on making it easier to understand differences in the quality–and not only the cost–of care.
Quality transparency has long bedeviled the health care industry. While quality reporting has improved over the years, it remains difficult for the average consumer to understand, analyze, and accurately apply quality ratings to the health care choices available in their network and covered by their plan design. There also has been no single place to see an aggregated, actionable view of provider quality, collating the different pertinent quality measures, from primary care to specialists to hospitals.
Our customers are dedicated to helping their employees make informed health care decisions and over the past few years, we have made significant progress in tackling this challenge together.
To make it easier for patients to make high-quality, high-value choices when searching for care, our solution provides a single, straightforward composite quality rating–or Q-score–for a given provider or procedure. Derived from a proprietary algorithm, we calculate the Q-score by aggregating, analyzing, and weighting data from 17 reputable third-party quality sources, from CMS to The Leapfrog Group to Bridges of Excellence, and more.
Example Data Sources:
Q-scores are personalized to the user based on their clinical claims, search history, and user profile. For example, if a user has claims related to diabetes, Q-score will take that into account, applying higher weighting to quality metrics associated with diabetes care, and elevating relevant providers and hospitals accordingly.
But this information is only effective if the patient uses and applies it to their decision-making process. To address this, a search for care within our platform serves up a short, digestible list of providers, synthesizing information on quality (as measured by Q-score), cost, patient ratings, and convenience. We also provide context for why a physician is displayed, alongside cost estimates, to make the choice easier for the user.
All of this functionality was developed to account for what people really want when choosing care: a high-quality doctor with expertise in what ails them; to be able to afford and conveniently access their care; and the ability to incorporate other patients’ reviews of the provider into their decision.
When patients are enabled to make the right choice based on these factors, health outcomes improve. In fact, current Castlight customers’ employees who chose a recommended primary care provider experienced both higher quality care, with less inpatient hospital days per year–and lower cost care, with reduced total spend per patient per year.
Unfortunately, for most patients, navigating the complex health care system is a difficult burden on top of actually managing their health and wellbeing. But with the combined efforts of the government, employers, and innovative solution providers to enable patients as informed health care consumers, higher quality, lower-cost care is possible.