Health Care Transparency

hnycubannerEvery month we’ll host a call and bring in an expert speaker to talk to you about a hot topic and then give you the chance to ask questions

February 18, 2016

On February 18, Jess Hand and Beth Eastman of the Florida Center for Health Information and Policy Analysis demonstrated how consumers and advocates in Florida can access the existing price and quality data collected, analyzed, and displayed on the FloridaHealthFinder.gov website.

If you missed the session, you can listen to the link below and follow along at FloridaHealthFinder.gov to learn how to access the information currently available about the price and quality of health care at all hospitals, nursing homes, and assisted living facilities in Florida. There is also information about health insurance plans, Medicaid managed care plans, and pharmacy costs.

The Florida Center for Health Information and Policy Analysis is available to deliver the webinar about FloridaHealthFinder.gov for any group in the state (large or small). The link to request a webinar is available here.

This was a timely topic as Florida consumers want to purchase high value health care services. As we commonly understand it, value is a combination of price and quality. Understanding health care price and quality has never been more important to health care consumers and policy-makers. Even as more than one million more Floridians gained health insurance coverage in the past two years, cost-sharing and out-of-pocket expenses for health care has also increased — making price and quality transparency an imperative.

Proposed Health Care Transparency Bills (Senate Bill 1496 & House Bill 1175)

The dataset available at the FloridaHealthFinder.gov may soon become much larger. In the current legislative session, the Senate and the House are considering health care transparency bills that would direct the Florida Agency for Health Care Administration to contract with a national vendor to create an All Payer Claims Database that will expand the currently available retail price information to include how much insurance companies actually pay for care after their contract discounts are applied.

These bills SB 1496 and HB 1175 include other consumer protections by requiring hospitals and providers to display their retail prices and average insurance payments for commonly types of health services and procedures in a manner meaningful to consumers. They would also have to display information about discounts and charity services available to people without insurance.

Insurance companies would be required to maintain online tools for consumers to calculate their cost-sharing responsibilities before scheduling their care — for in-network and out-of-network providers.

There are some differences between the Senate and House version of the Transparency bills.

HB 1175 includes requirements for Agency for Health Care Administration to develop a hospital “culture of safety” survey and display the results by hospital on the FloridaHealthFinder.gov. This would be a ground-breaking change for public reporting of this type data. Nearly all hospitals collect this data today, but few share the information publicly, as described by this U.S. News health report. The HB 1175 also requires hospitals to disclose “facility fees” (surcharges for services provided by a hospital-based or hospital owned clinic or facility).

SB 1496 directs the Insurance Consumer Advocate to act on behalf of Florida consumers who file a complaint to determine if a hospital has billed them “unfair” amounts and establishes financial penalties for hospitals that charge unconscionable prices. The Senate version also extends advance price disclosure rules to home health and durable medical equipment agencies in addition to the requirements for hospitals and physcians that are included in both bill versions.

The current trend toward health care transparency is excellent news for Florida’s consumers. Having data from an All Payer Claims Database is a fine next step. Florida CHAIN will continue to work with the Florida Center for Health Information and Policy Analysis through our participation in the State Consumer Health Information and Policy Advisory Council to advocate that FloridaHealthFinder.gov continues to develop easy-to-use and relevant tools for consumers to evaluate quality and price in their search for high value health care.

View this Health News You Can Use recording: