Florida Matters: PriceCheck Florida

Apr 26, 2016
Originally published on April 26, 2016 3:42 pm

Real prices for health care are complicated and oftentimes secret. Health News Florida, WUSF and WLRN have launched an online guide to bring clarity to health care costs. PriceCheck Florida is a database of prices of common health care procedures and supplies.

You can search the database, and you can contribute information about the prices you paid.  

This week on Florida Matters (Tuesday, April 26 at 6:30 p.m. and Sunday, May 1 at 7:30 a.m.), we sit down with project founder Jeanne Pinder and Health News Florida reporter Sammy Mack to talk about how the database works and why it’s needed. We also feature a discussion on the impact of health care costs on employer-based insurance.

WLRN's Tom Hudson recently sat down with Pinder and Mack for a look at what PriceCheck is all about.

MACK: There’s actually a lot of disagreement around what transparency even means in health care. What we’re trying to do is get enough information about what people are paying to start to understand what some of the influences are on the marketplace here.

HUDSON: Jeanne, so, if there’s disagreement about transparency, is there going to be disagreement about what a price paid is?

PINDER: Yeah, well, it’s interesting that you ask that. We feel like you should know what stuff costs. So we as journalists survey providers on their cash or self-pay prices for 30 or so common shoppable procedures. What would you pay as an uninsured person? And from a range of providers in the Miami and Tampa Bay areas, on things like an MRI, an cardio stress test, a CBC blood test, and IUD, shoppable things like that.

HUDSON: So how does this work? How does this tool work? What’s behind the scenes with the technology?

PINDER: So we load the database with the prices that we’ve collected from this range of providers, and then we make it really easy for you to share your prices – what you were charged, what insurance paid, what you paid, and also there’s a box for how did you feel about it.  You can give us your email if you want to so we can reach back to you and look at your EOB (explanation of benefits) and then you see your figures in context with other people’s figures and with those cash prices.

HUDSON: Sammy, there’s plenty of other transparency tools out there. Most of the major health insurance companies have a transparency tool. Some big employers will have their own transparency tools. What’s different about PriceCheck?

MACK: Well, what’s different about PriceCheck is that when you look at the transparency tools that insurance companies have, for example, you can access the information about what gets paid on your behalf, but you have to be a member. And what we’re doing, is we’re asking people to tell us those numbers, which is data that they own as patients who have had this paid on their behalf, and we’ll be able to look sort of across platforms, across payers and insurers and all of that. Because what happens frequently is that negotiated rate, so what actually gets paid – not what gets charged – but what actually gets paid on your behalf is kept behind a non-disclosure agreement between the providers or the hospitals or the doctor’s office or the big group, and the insurance company. And that is where we have as journalists run into kind of a roadblock in terms of understanding what things truly cost in the system and what’s driving those costs, so hopefully we can get enough of that information that we’ll be able to tell really meaningful stories out of it that we haven’t had access to before.

HUDSON: Any early trends you’ve been able to pick up in the database you’ve constructed already for Florida?

PINDER: The biggest trend, I think I would say, is that people are really upset about health care pricing and they want answers. They also want to contribute to a solution. We’ve learned that people are really eager to put their health care information online, which was a total surprise when we started out doing this. And we’re really happy as journalists to join hands with our communities on these efforts.

As far as early trends in the Florida data, you guys, Florida you have really, really, really low MRI prices. Like, we should all be flying down to Florida to have our MRIs. It’s that much cheaper.

HUDSON: Is that a function of completion, of the number of MRI facilities that are available?

PINDER: I expect that we will figure it out and write a great story about it.