A bill to help patients reduce their health insurance premiums by shopping for healthcare received the endorsement on Wednesday of Florida Gov. Ron DeSantis, who said the proposal will build on the state’s efforts to make public the prices charged by hospitals and other medical providers.
“There needs to be a system so that they [patients with health insurance] can actually benefit by making informed decisions,” DeSantis said at a press conference held at Memorial Regional Hospital, a taxpayer-supported hospital in Hollywood.
DeSantis was joined by Mary Mayhew, director of the Agency for Health Care Administration, and Florida Sen. Manny Diaz Jr. of Miami, who sponsored the so-called Patient Savings Bill in the Senate.
The bill would not benefit Florida’s estimated 3 million people without health insurance coverage, nor would the proposal require health insurance companies and hospitals to do anything new or different. Instead, Diaz said, the bill would “create a structure” for insurers to provide incentives for their members to shop for lower-priced care.
“If there’s a savings in that choice,” he said, “the insurer is going to share that with me.”
While many insurers already offer online tools to help their members estimate the cost of getting an MRI or a blood test or other standard procedures, the cost of emergency medical care or a scheduled surgery can vary depending on the patient’s health condition and other factors.
In addition, coverage for most insured patients is limited to the hospitals and doctors in their plan’s provider network, which would restrict the amount of shopping they can do for healthcare.
Diaz acknowledged his proposal would not be effective for patients in those situations. But he said that consumers are demanding relief from the high cost of healthcare, and he noted that some hospitals have responded by creating their own transparency tools, such as the online price portal created by Memorial Healthcare System, the public hospital network for South Broward.
Matthew Muhart, vice president and chief administrative officer for Memorial, demonstrated the online price portal by shopping for a CT scan of the brain using the insurance coverage provided by his employer. The cost was estimated at $338.
For an uninsured or self-pay patient, the tool showed a cost of $350. However, that price does not include the services of a physician, the interpretation of the CT scan or any follow-up care that might be needed as a result of the findings.
Florida’s healthcare price portal showed the state average for a similar procedure at $842 and a national average price of $745, illustrating the wide variation in healthcare prices.
The high cost of prescription drugs, hospital care and insurance coverage is “the number one issue” for patients, DeSantis said. But he emphasized that the Patient Savings Bill would contain no mandates for hospitals or health insurers.
“This is one tool that we’re looking for to try to create a downward pressure on the cost of all this stuff,” he said.
Without regulation, however, hospitals and healthcare providers are also free to raise their prices to match a competitor’s. But DeSantis said he doesn’t think that will happen.
“I don’t think what we’re doing would drive price increases,” he said. “I think there are other things beyond our control that would do that.”