and Richard P. Shannon

For decades, Pennsylvania has been considered the gold standard in the reporting of medical outcomes. This reputation is due to the work of a small state agency known as the Pennsylvania Health Care Cost Containment Council, or PHC4.

As chairman of and a cardiology adviser to the agency's Technical Advisory Group, respectively, we have had the privilege of participating in this process of promoting health-care transparency. And as practicing physicians, we know we need credible data to improve the quality of the care we deliver and to address the pervasive waste and preventable costs that are making it increasingly difficult to afford.

The Pennsylvania legislature and Gov. Rendell recently gave PHC4 a five-year extension and an expanded mission, which we applaud. But the agency needs adequate funding to remain a catalyst for innovation in health-care delivery and transparency. Its funding for this fiscal year was cut by 47 percent, from $5.3 million to $2.8 million. Furthermore, it has sustained a 37 percent reduction in its workforce in the past 18 months.

Quality is integral to today's health-care agenda, and quality depends on transparency and accountability. Health care needs the rigor of transparency stimulated by PHC4, especially if we are to transform our often dysfunctional system.

The agency enables stakeholders to ask provocative questions in ways that simply could not happen without good data. It has spurred improvements in hospital performance and health outcomes, stirring a national conversation about hospital-acquired infections, for example. Other examples of its impact:

Mortality rates in Pennsylvania hospitals have dropped significantly below national averages over the past 15 years of PHC4 reporting. The agency estimates that this has saved 49,000 lives and $1.7 billion.

Based on findings from a recent American Journal of Medical Quality study, the agency's public reporting process prevented 1,500 deaths in one year in just six disease and treatment categories.

In-hospital mortality rates for coronary bypass surgery have dropped almost 50 percent since 1994, when the agency began reporting.

Statewide hospital-acquired infections dropped 8 percent from 2006 to 2007, for a savings of $370 million in hospital charges.

These are just a few of PHC4's measurable achievements, and they show why the agency's work is so highly regarded. No other state has demonstrated such successes, nor has the federal government.

Health-care providers must be prepared to embrace outcome reporting for several reasons. For example, a number of recent studies have shown that avoidable hospital readmissions are a widespread, costly problem. PHC4 has been attacking waste by reporting readmissions for several years.

Publicly reporting on hospitalizations across episodes of care is also one way to understand the costs of treating certain conditions, particularly those related to chronic diseases, and to improve the lives of those who suffer from them.

Similarly, there must be more reporting on medical errors and so-called "never" events - preventable errors that should never occur - that drain resources from the system.

With all the troubling issues around health-care quality and safety in the headlines, it is critical that the state's health-care watchdog be as effective as possible. PHC4's data illuminate preventable negative results in the system and give providers, patients, and insurers opportunities to improve quality, reduce costs, and save lives. A minimal investment in PHC4's budget is one of the best values in state government.