Pricecheck

Image courtesy of Everydayplus at FreeDigitalPhotos.net

Look closely at a bill from your health care provider, and there's likely a sigh of relief your insurance company negotiated a better rate than the initial charge.

But those negotiations are often secret, and it's hard to compare one insurance company to another.

So how do you know whether they are negotiating the best price?

Accident victims with private insurance are getting surprised by sky-high ambulance bills and Florida Insurance Consumer Advocate Sha 'Ron James wants to do something about it.

It has been four months since WLRN launched Pricecheckan online guide to bring clarity to health care costs in Florida.

California Aims To Limit Surprise Medical Bills

Sep 11, 2016

When it comes to navigating the intricacies of health insurance, Cassie Ray considers herself a pro. She actually reads her policy, including the fine print.

So when the 57-year-old from Fairfield, Calif., needed routine follow-up surgery after a mastectomy, she did her homework. "I looked up on my insurer's network and made sure the outpatient facility that I was being referred to was in my network," Ray says.

A month later, she received an unwelcome surprise: a $580 bill for an out-of-network anesthesiologist.

When Brenda Sokolowski turned 50, she followed national recommendations and made an appointment for her first screening colonoscopy.

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.

WLRN

  Transparency is the new buzzword in health care with consumer demand fueling changes to state laws and giving birth to websites that publish prices for medical procedures.

WUSF partnered with WLRN in Miami to launch their own database called PriceCheck. But we're not the only game in town.

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.

Florida is the ninth worst state in the U.S. for having a baby.

Here's a typical scenario when you have a medical problem. You go to your doctor's office, then have to run across town to a lab for a blood test and then you also have to get an appointment for an X-ray or MRI. There's a good chance this will all require a phone call — or a lot of phones calls — with your insurance company.

It's a hassle and it's time-consuming.

But for many people it's even worse than that.

  Medical debt is one of the leading causes of bankruptcy in the United States. Having health insurance is no guarantee against being swamped by bills after an emergency or a big procedure.

But one Palm Beach County man has found there’s room to negotiate.

Lisa Rosario/Albuminarium

Having a baby is expensive, even with insurance. A new report says the average cost varies greatly across Florida and nationally.

The report by Castlight, a company that looks at millions of patient claims a year, ranked by price the 30 most populated U.S. cities, including Tampa, Orlando and Miami.

United States Marine Corps (Wikimedia Commons)

When it comes to health care in Florida, it pays to shop around.

The cost of a common MRI can vary by thousands of dollars depending on where you go to get it.

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.

As Hospital Chains Grow, So Do Their Prices For Care

Jun 13, 2016
USC researchers; Blue Shield of California claims data

As health care consolidation accelerates nationwide, a new study shows that hospital prices in two of California’s largest health systems were 25 percent higher than at other hospitals around the state.

WLRN's Topical Currents looks at Health News Florida’s PriceCheck project . . .  a community-created guide to health care costs.

Patients can go to Health News Florida's website and enter medical bill or insurance company “explanation of benefit” details.  An easily accessed data-base is thus developed, which shows an assortment of procedure prices.

Medical bills can be incredibly confusing and difficult to read.

But do you have a better idea?

No, seriously, do you?

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.

WLRN

During a conversation about health care recently with WMFE, the chief executives of two major hospitals in Central Florida said making prices more transparent to patients is important, but the task itself is hard to accomplish.

Florida Blue

The insurance company Florida Blue says its rate increases were published too soon on the Obamacare website.

The numbers that were briefly available showed as much as an 11 percent price increase on some plans.

Charles Elmore of the Palm Beach Post first saw the numbers when he was surfing the HealthCare.gov website.

WLRN

Patients looking for more transparency in health care costs won’t usually find it on the bill from their medical provider.

Health-care prices are complex and in many ways secret—which can affect how much you end up paying for your health care.

But not everyone agrees on what transparency in health-care pricing should look like.

You can listen to a story about what we mean when we talk about transparency here:

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.

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.

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.

Coming up at noon on Friday, April 22, the Florida Roundup on WLRN in Miami will feature a conversation about PriceCheck with founder Jeanne Pinder and Health News Florida reporter Sammy Mack.

You can livestream the show from anywhere at WLRN.org or on 91.3 FM in South Florida.

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.

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