Written by Larry Sobal, CEO, Appleton Cardiology Associates

There are many movements afoot to expand the availability of information regarding the quality and cost of the health care.

This concept, generally termed as "transparency," hopes to spark competition among health care providers to demonstrate to purchasers and consumers who offers the best value.

As the push for transparency grows, an abundant new crop of online tools is emerging which are all designed to help consumers and employers manage their medical expenses and make better health care decisions. Today's column will highlight some recent additions.

In a move taken to improve the quality of U.S. hospitals, the Centers for Medicare and Medicaid Services has developed new health outcome measures for all hospitals. Beginning this month, CMS will post risk-adjusted 30-day mortality rates for Medicare patients hospitalized with a discharge diagnosis of acute myocardial infarction and heart failure.

CMS will describe in general terms each hospital's performance for MI and heart failure, and these results are to be posted on the Hospital Compare Web site (www.cms.hhs.gov/Hospital QualityInits/25_Hospital Compare.asp).

Another interesting new site helps employers evaluate the merits of utilizing a health plan that incorporates incentives for providers. These programs, commonly referred to as pay-for-performance, or P4P plans, are emerging in the market but employers have struggled to quantify the impact of this plan design. In response, the Leapfrog Group has unveiled the ROI Estimator, a tool for employers and health plans to estimate the costs and financial benefits of using the Leapfrog Hospital Rewards Program, a standardized incentive program that can be licensed and used by health care purchasers and plan sponsors.

The ROI estimator, found at www.ROIestimator.com, is a free survey that takes about 10 minutes to complete. It shows the employer the potential return on investment — in both lives saved and money saved — from implementing a P4P program.

One of the more elusive aspects of transparent health information has been the price of health care. A new site opened last month and claims to unveil the true cost of health care, ironically, for a price. Healthgrades Inc. has launched a feature known as Medical-Care Cost Reports (www.healthgrades. com). This site provides pricing information on 42 of the medical procedures performed most often in the United States. Thirteen more procedures will soon be added for a total of 55.

For $7.95 per procedure, users receive a medical cost report, including the average amount charged by providers in their region, the average amount negotiated for the procedure by health plans, and the average out-of-pocket expenses. The data is drawn from 80 health plans covering 55 million people.

There are many excellent Web sites to fulfill your transparency needs. A recent study by comScore showed that between January and March, 55.3 million U.S. Internet users visited health Web sites — a 12 percent increase from a year earlier.

The top four viewed sites: