In the escalating war of words against his former industry, Florida Gov. Rick Scott has referred to hospitals and the prices they charge consumers as “unconscionable” and “unfair” while also proposing reforms intended to empower patients by increasing transparency in healthcare costs.
This week Scott, the former chief executive of a for-profit hospital chain, stepped up his campaign by issuing an open call for Floridians to submit their personal stories of “price gouging” to his appointed Commission on Healthcare and Hospital Funding.
“By requiring hospitals to post pricing information online,’’ he said in a statement, “we will give patients the tools necessary to prevent and report the deceptive practice of price gouging.”
But the governor already turned down the opportunity to build what healthcare cost experts consider the gold standard of hospital pricing: an all payer claims database, or a repository of actual prices paid by insurers and government programs to hospitals for their services.
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In 2014, the state’s Agency for Health Care Administration requested about $5 million a year to build and maintain a database it dubbed the Health Care Cost Analytic Tool or HCCAT.
We will give patients the tools necessary to prevent and report the deceptive practice of price gouging.
Gov. Rick Scott
In the funding request, AHCA officials said they had statutory authority to compel hospitals, doctors and health insurers to submit the data as “necessary to carry out the agency’s duties.” They planned to include in the database Medicaid and managed care claims, and gradually expand the repository to include private insurers’ medical, pharmacy and dental claims.
“The HCCAT provides the ability to understand how and where health care is being delivered and at what cost,” the funding request stated.
But the governor did not include AHCA’s request in his budget proposal that year, and since then Scott’s administration has cut 81 positions at the agency and reduced its funding by $64 million a year.
Bruce Rueben, president of the Florida Hospital Association, said his group supports the creation of a statewide repository of hospital prices for consumers.
“A comprehensive database would provide meaningful information about health care quality, costs and access,’’ he said.
Jackie Schutz, a spokeswoman for the governor’s office, said she did not know if AHCA or any other state agency has submitted a budget request this year for an all payer claims database. But she said the governor will present his budget recommendations “in the coming weeks.”
Florida legislators have enacted or amended statutes and regulations more than a dozen times since 1985 requiring some level of transparency and disclosure from hospitals and physicians, but not insurers.
Hospital pricing has emerged as one of the governor’s key issues for addressing a reduction in public funding for Florida hospitals, particularly those that care for large numbers of uninsured patients, such as Miami-Dade’s taxpayer-owned Jackson Health System.
Jackson Health expects to lose $50 million in hospital payments next year from a combined federal-state program called the Low Income Pool that is being phased out.
Florida has a state-mandated website managed by AHCA at floridahealthfinder.gov that gives consumers average and total charges for a variety of medical services by hospitals — but not specific reimbursement rates. The site does not list the price actually paid for care. It lists only the amount initially charged by the healthcare provider — a far less reliable indicator of what consumers will actually pay.