PriceCheck: Miami Hospital Takes Stab At Price Transparency

Sep 6, 2016

Hospitals keep a list of what they charge for health care. But if you have insurance, that charge may have nothing to do with what your insurance company has negotiated and what your out-of-pocket expenses would be.

One South Florida hospital is experimenting with a new way to give patients a price quote on their health care.

What makes Care Quote — from Jackson Health System in Miami — different from a typical estimate is how it accounts for an individual’s insurance plan.

Potential patients call a number or fill out an online form with their insurance information. They tell Jackson what they’re looking to have done. And then Jackson staff basically runs those details through the same process that gets used for billing.

Myriam Torres, a vice president with Jackson, says the Care Quote tool satisfies new price transparency regulations. And it comes at a time when patients are asking more questions about what their care may cost.

“The insurance companies are holding patients responsible for a larger portion of the care and the patient has options,” Torres says. “They can shop around.”

The tool does not let patients compare what the same procedure might cost with different insurance, or at different hospitals. And for now, it reflects the facility fees, but not what doctors charge.

Telisa Lyons, who leads Patient Access at Jackson, says most of the quotes requested so far have been for maternity care and expensive imaging services like MRIs and CT scans.

“The cost of those services tend to have a higher out of pocket than some of your general services,” Lyons says.

Jackson administrators hope the tool will attract more price-conscious patients with insurance.