price transparency

Health care costs are a pain. That's why Health News Florida has PriceCheck, an online tool to help you compare costs of common health procedures. This week on Florida Matters we're featuring people who shared their own frustrations and sticker shock!

After battling for years over how to make healthcare more accessible and affordable, Florida lawmakers landed on a compromise. Instead of expanding Medicaid to cover more people, they decided during last year’s session to attack the cost of care directly, creating a database to make procedure pricing transparent.

Florida patients could soon have access to more information about the average costs of their prescription drugs.


Health News Florida, WLRN and WUSF have launched PriceCheck, a reporting project aimed at bringing clarity to the cost of health care in Florida. On today's Florida Matters, we'll get an update on what the PriceCheck team has learned since its launch, with Health News Florida editor Julio Ochoa, PriceCheck founder Jeanne Pinder, and WLRN reporter Sammy Mack.

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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.

Catalyst For Payment Reform

Florida and 42 other states fail to give the public easy access to health care pricing, according to a new report.

People who die in the hospital undergo more intense tests and procedures than those who die anywhere else.

An analysis by Arcadia Healthcare Solutions also shows that spending on people who die in a hospital is about seven times that on people who die at home.

In a move that might actually help health care costs become more transparent, some hospitals are starting to give patients detailed information about what their upcoming visits will cost in an attempt to get them to pay ahead of time, according to the website Modern Healthcare. 

ProPublica

A database set up by ProPublica detailing the prescribing habits of doctors around the country may be luring the wrong audience, the publication recently reported.

Associated Press

Prescription drug costs are not only a problem for consumers. Health care providers are worried about it too.

When the health insurance premiums got to the point that they were higher than her mortgage, Renee Powell started to become cynical.

"There was something in me that just kind of switched," said the mother of two from Bartlesville, Okla. "I was OK with paying $750, but when it became about $100 more than my housing costs, it upset me."

Powell is an epidemiologist and used to work for the state in Oklahoma City. She had affordable insurance through that job.

Need knee replacement surgery? It may be worthwhile to head for Tucson.

That's because the average price for a knee replacement in the Arizona city is $21,976, about $38,000 less than it would in Sacramento, Calif. That's according to a report issued Wednesday by the Health Care Cost Institute.

Beginning in July, if you have health insurance and go to an in-network hospital but a doctor who is not in your insurance plan’s network helps you, you aren’t supposed to get a surprise bill.

Ask what something costs in medical care and you could easily come back with a half dozen different answers. Health care costs are complex and often secret.

That’s part of why WLRN, WUSF and Health News Florida are launching PriceCheck, a reporting project aimed at bringing clarity to the cost of health care in Florida.

Trying to get a handle on what makes PriceCheck different from other looks at health care costs? Here are some frequently asked questions before you start searching our database.

The Obama administration is recruiting as many as 20,000 primary care doctors for an initiative it hopes will change the way physicians get paid and provide care.

The program, which was announced Monday, will be run by the Centers for Medicare and Medicaid Services. The aim is to stop paying doctors based on the number of billable services and visits provided to Medicare beneficiaries and instead to tie payments to overall patient health and outcomes.

At 85 years old, Alpha Edwards did not expect to be out of savings or to have $3,000 of credit card debt.

"I don't do anything that costs money," Edwards says. "I can't."

The problem started four years ago, when Edwards moved to Miami Springs, Fla., with her little brown dog. Her husband had recently died, and Edwards wanted to be closer to her daughter.

Edwards regularly sees doctors for her chronic lung disease and her pacemaker. And not long after she moved, she needed a cardiac procedure.

Governor Rick Scott has raised the profile of balanced billing in the healthcare system and now the Florida legislature is trying to tamp down on it. A Senate bill limiting how and when hospitals can charge patients for out-of-network services is on its way to the chamber floor.

Barry Gutierrez/NPR

The Florida Legislature has killed a measure that would let doctors increase what they charge patients for copies of medical records to $1 a page.

The Internet allows savvy consumers to comparison shop for big ticket items. Those items may soon include medical procedures.

Pharmacies across the U.S. will begin receiving shipments of a generic form of the revolutionary cancer pill Gleevec this week after the drug lost its patent protection on Monday.

The generic version of drug, known as imatinib, is likely to cost about 30 percent less than brand-name Gleevec, says Kal Sundaram, the CEO of Sun Pharmaceuticals, the Mumbai, India-based company that will make the first generic.

'Transparency' Backed in Senate Amid Questions

Feb 1, 2016
healthcare.gov

A Senate budget panel last week approved a bill that seeks to increase transparency about health-care costs, but the measure drew pointed questions from some lawmakers.

Transparency, 'Telehealth' Bills Moving In House

Jan 21, 2016
myfloridahouse.gov

Continuing to look for different approaches to health care, a House committee Wednesday approved bills that would require more transparency about medical costs and seek to expand the use of "telehealth."

Lottie Watts / WUSF

A final report from Gov. Rick Scott’s Commission on Healthcare and Hospital Funding is recommending that Floridians should be able to find out ahead of time what it will actually cost before going into the hospital for non-emergency treatment.

Scott's Hospital Commission Ready To Wrap

Jan 19, 2016
Lottie Watts / WUSF

Gov. Rick Scott's hospital commission is set to complete its work at a meeting Tuesday in Tallahassee.

The Commission on Healthcare and Hospital Funding, which Scott created last year to delve into health financing and regulatory issues, is scheduled to hear from two health-care experts and Sen. Don Gaetz, R-Niceville, before reviewing a draft of the panel's "final observations."

Hemophiliac patients participating in the Medicaid program could have more options for treatment in Florida this year. 

The Florida Agency for Health Care Administration wants the federal government to allow three companies to provide care for patients with the rare blood-clotting disorder. 

While hemophilia is rare, treating it is expensive: an average of more than $130,000 a year for each patient. There are just 183 patients on Medicaid with hemophilia, but treatments for those 183 patients cost $24 million.

The Florida Hospital Association has unveiled a new site dedicated to helping consumers understand costs. The website, MissionToCare.org, pulls information from both the state and federal governments to clear up the financial picture.

Lawmakers Call For Greater Price Transparency

Jan 8, 2016
Albuminarium

Two Republican lawmakers Thursday proposed wide-ranging bills that seek more transparency about the prices of services at hospitals and other types of health-care facilities.

Sarah Jackson had quit abusing drugs and had been sober for six months when she found out she had hepatitis C.

"That was weeks of not sleeping and just constant tears," she says. "I had already put a lot of that behind me and had been moving forward with my life and this was just a major setback."

To get rid of the infection, her doctor prescribed Harvoni, one of the new generation of highly effective hepatitis C drugs. But Jackson never started the treatment because her insurance, Indiana's Medicaid, refused to pay for it.

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