Florida hospital price website targets ‘opaque’ system

Posted at 8:56 AM, Nov 05, 2019

TALLAHASSEE, Fla. --- After three years in the making, the state on Monday launched a website meant to help consumers shop and compare the prices of hospital services --- but it already is coming under fire from a group that represents hospitals across Florida.

Gov. Ron DeSantis announced the launch of the Florida Health Price Finder website at a Walmart Supercenter in Pinellas County.

“Patients just need information,” DeSantis said. “This has been a very opaque system for so long.”

The Florida Health Price Finder website,designed to help people search and look at how much hospitals charge for certain services, is based on claims information from 90 percent of the insurers that were required to report data to the state, Agency for Health Care Administration Secretary Mary Mayhew told The News Service of Florida.

Claims data information from Molina Healthcare, Capital Health Plan and Health First Health Plans was not included in what’s available for public review, according to AHCA.

Mayhew attributed the exclusion of some data to scheduling. She said that there wasn’t enough time for a contractor, the Health Care Cost Institute, to upload and process all of the companies’ claims data.

“We’re working to get those companies on as quickly as possible,’’ she said. “It’s a lot of data they have to submit and the vendor’s process with the data takes a long time. … This isn’t that any of those plans are not willing to participate, it was more driven by the prioritization of the larger plans and the vendor’s schedule.”

The website lists information for 44 frequently searched non-emergency procedures that are done at hospitals and ambulatory surgery centers across the state, listing the average costs paid to hospitals by insurance companies on a national, state and local level.

The goal of the website was to include site-specific cost information. But the data consumers have access to varies from county to county.

For instance, there is no information about childbirth and vaginal deliveries available from any hospital that operates in Brevard County, which is home to Health First Health Plans.

And consumers in Leon County have limited price information on just one of the general acute-care hospitals in the area. That means “comparing” the facilities for costs isn’t possible.

Consumers in Duval County can search the cost of joint replacements, but the website doesn’t have average costs for all of the hospitals that provide the services.

The inconsistencies in data relates to statistical methodology. For information to be statistically valid, Mayhew said, a minimum number of procedures need to be conducted at a facility.

“One of the points that we continue to make is that everyone should always reach out to the provider that they are interested in getting specific pricing information from,” Mayhew said. “This website is trying to get good information into the hands of consumers. But it’s not intended to fulfill the bottom line that every individual that is about to have a procedure done needs to be reaching out and calling.”

Florida Hospital Association President Bruce Rueben though, questioned just how “good” the data is.

“We are surprised that the Agency for Health Care Administration abandoned its longstanding practice of having hospitals review their pricing data before it’s publicly shared to ensure accuracy,” Rueben said in a statement to the News Service. “Since AHCA did not verify the data with hospitals and ambulatory surgical centers, its validity is unknown.”

Rueben maintained the website doesn’t accurately display the services hospitals offer and said that all inaccurate data needed to be “immediately corrected and publicly shared.”

Health care transparency has been a priority for House Republicans, who have contended that such moves are better solutions to driving down health-care costs than ideas such as expanding Medicaid enrollment to uninsured childless adults.

The website was the brainchild of former Gov. and now-U.S. Sen. Rick Scott, who promised taxpayers they would be able to shop and compare costs at every hospital in the state.

Scott, a former hospital-industry executive, moved to create the transparency website after a bruising battle with hospitals in 2015 over the proposal to expand Medicaid eligibility.

He convinced lawmakers to sign off on the establishment of an all-payers claims database so the state could get the claims data from all insurers that participated in the Medicaid program or the state employees’ health insurance program.

The goal of the "transparency" project was to put the information in a reader-friendly format on a state website so consumers could shop around for health care. More than $6 million has been committed to the creation of the website.

The efforts were hamstrung by lack of data collection from insurance companies. Florida-specific insurers and HMOs had concerns about providing claims data to the Health Care Cost Institute.

Florida Blue, which is the trade name of Blue Cross and Blue Shield of Florida, agreed to start submitting the claims data this year after it was assured that the state would protect “confidential and proprietary” information, spokeswoman Toni Woods said earlier this year. Woods said Florida Blue also was given assurances from the state that the Health Care Cost Institute does not own the claims data.

Despite the limitations, incoming House Speaker Chris Sprowls, R-Palm Harbor, praised DeSantis on Monday for getting the site up and running.

“The reality is, I always tell people that you can do something. You can pass a law and sometimes that’s hard. Implementing that law is even harder. And for three years we wanted to build this information superhighway to allow the marketplace to respond,” said Sprowls, who will become speaker after the 2020 elections. “But the construction vehicles were there and nobody was working. Until Gov. Ron DeSantis came in and said, ‘Patients in Florida have waited long enough.’ “