Governor Calls For Hospital Price Transparency But Should Proposal Extend To Others?

Oct 2, 2015

Credit Mark Hillary / flickr.com

Governor Rick Scott is pushing for greater healthcare cost transparency in hospitals.  The move comes as Florida faces the loss of more federal health care funding next year, and growing concerns about the state’s healthcare costs.

Scott and the hospitals have been at odds all year. Now the Governor is accusing them of price-gouging patients.  Scott founded one of the largest hospital chains in the United States, but when asked what he’s done to increase transparency, Scott is pointing instead to his urgent care company.

"I put all the prices on a menu board, just like Starbucks or anything else, you just walk in. What’s it gonna cost to see a doctor? What’s it gonna cost to get a procedure? The truth is, we ought to be able to do that with all our healthcare costs," he said.

Urgent care centers have been posting prices for years. But not every healthcare entity is transparent about its costs. Recently Rep.Jason Brodeur cited cost differences in procedures between hospitals and other centers as he endorsed an extension of ambulatory care.

“The average charge for a colonoscopy by site was $4,800 at a hospital-based facility, and $2,000 at an ambulatory care center," Brodeur explained.

And the state recently announced health insurance costs would rise an average of 10 percent. Florida Center for Fiscal and Economic Policy Health Analyst Greg Mellowe says there’s no way to understand what factored into those decisions:

“Claiming information like that is trade secrets and shouldn’t be disclosure to the public is wrong and undermines the message they want consumers to be aware and informed.”

A report from the non-profit Catalyst for Payment Reform gives Florida along with the majority of other states, an “F” when it comes to healthcare cost transparency.

“The variation in the prices doesn’t have much rationale to it," she said. "You can see prices in the U.S. can vary as much as 700 percent,"  the group's Andrea Cabellero told the Governor's Commission on Hospital and Healthcare Funding at a recent meeting.

The commission is also concerned about a long-standing issue: balance-billing. That happens when patients get a bill for services not fully covered by their insurer.  Three years ago, a plan in the Florida legislature would have made it far easier to find out what health care services cost. The proposal -- brought by future House Speaker Richard Corcoran -- would have expanded a state requirement that certain providers post prices of common procedures. It was killed in the Senate and opposed by the Florida Medical Association. But the bill would have applied to hospitals, ambulatory care centers, diagnostic imaging businesses and doctors who work in hospital settings.  All are places where patients could get unexpected bills. Much of it comes when patients have to go to emergency rooms, and the average consumer may not know whether a provider is in, or out of network.

“My mother-in-law went to the hospital, and she stayed overnight. Then she had a bill for $12,000 and we were surprised, because it costs so much," said Hospital Funding Commissioner Eugene Lamb.

The Florida Hospital Association says it agrees there should be more price transparency in the system. The organization’s President, Bruce Rueben agrees it should be easier for consumers to find out what services cost. But he says the way Governor Rick Scott has gone about placing blame on hospitals is wrong. The Governor accuses hospitals of price gouging patients:

“We’re very disappointed with the mean spirited tone of this press release that calls for protections against hospital pricing," Rueben said. "It’s discouraging when we’ve been working on our own proposal for increased transparency around price and clinical performance.”

The Governor’s hospital transparency plan would require hospitals to post prices and average payments in their website. Scott also wants patients to be able to pursue complaints of hospital "price gouging" with law-enforcement and regulators. The FHA says it supports many of the Governor’s ideas, but disagrees with his characterizations.

Florida lawmakers could expand the Governor’s plan to include other healthcare providers. The discussion comes as the state faces the loss of even more federal healthcare funding—and expects Medicaid costs to continue rising.