Hospital commission talks "price gouging" and patient choice
Making medical prices as easy to know as items on a restaurant menu won't be easy and, alone, won't guarantee lower health care costs, a group of experts told Gov. Rick Scott's commission on hospital funding.
The Commission on Healthcare and Hospital Funding held its 11th meeting Tuesday, this time on the Florida Gulf Coast University campus south of Fort Myers. The bulk of the three-hour meeting focused on ways to improve patient choice and make medical costs available to patients before they need treatment.
"Research has shown that price transparency can reduce health care costs and improve outcomes," said David Newman, executive director of the nonprofit Healthcare Cost Institute, which operates the medical price estimating website, guroo.com. "But I want to be clear that price transparency is not going to be a silver bullet in the health care system."
The nine-member commission's mission is to investigate taxpayer funding of Florida's health centers and insurers. Gov. Scott has also proposed legislation to require health care providers to disclose the costs of medical treatments and information about their financing.
Such prices tend to be estimates, because each patient has unique medical needs, Newman told the panel. And people needing medical care may have a limited number of providers from which to compare, depending on the size of their communities, he said.
Some studies suggest that transparency may drive up prices, as some health care providers learn their competitors are successfully charging higher rates. Finally, he said many medical situations don't lend themselves to reasoned cost comparisons.
"In the middle of my heart attack I'm not going to pull out my iPad Mini and begin shopping for services and suggest that the ambulance drive past two high-price, moderate-quality hospitals in order to waste another 15 minutes to get me to a value-based hospital to receive my health care services," he said. "So, there's a limit to what can be done."
Another presenter, Dr. Lee Gross, a private practice physician in North Port, touted the benefits of "direct primary care" practices, which shun insurance and typically just charge patients a regular fee for a broad range of services.
Gross' practice, similar to fee-for-care "concierge" practices, charges individuals $50 per month for a variety of outpatient services and testing. That, Gross said, cuts out the middleman — the insurance companies — and makes health care more efficient.
Patients can otherwise get high-deductible catastrophic insurance to cover any high-cost emergencies, he said.
"Why don't we have more direct relationships with our patients, because that is the stuff that starts driving up the cost of health care," Gross said. "Anytime some person that doesn't need to be touching the patient, touches the patient, the costs go up."
The commission also heard from Naples resident Lee Dixon, who received a bill for more than $5,000 after his son received ER treatment for a broken ankle in August at North Naples Hospital. Dixon complained that bill to his insurer included a $1,700 charge from the emergency physician, separate from the ER charge.
"When literally all the doctor did was give him a pain pill and look at three X-rays on a computer screen," Dixon said. "And she didn't actually look at the X-rays. She had to send them to a pediatric orthopedist to have him make the diagnosis."
Dixon said he does not yet know how much of the costs his insurer will cover. Hospitals negotiate with insurers to set prices for given medical treatments. Out-of-pocket costs vary, depending on individual policies.
Dixon's was the only local complaint about medical bills presented on Tuesday. The commission has posted 100 Florida cases of alleged medical "price gouging" on its website.
Patrick Hale, a sales manager for the health care information technology company, Castlight Health Inc., said patients need to know about health care options, not just prices. He said one Castlight effort helped a client company reduce employee ER usage sharply by steering them to tele-medicine programs.
"So if it's just a sore throat or something they know this is another option available to them," Hale said. "It's three in the morning, and the kids are crying, it's very hard to find that information. So it's available to you 24/7."
Lee Memorial not invited to hospital transparency hearing
Representatives from Lee Memorial Health System, which operates four of Lee County's five acute-care hospitals, attended the meeting but did not make any statements.
Sally Jackson, the health system's director of government and community relations, did not comment on the commission's decision leave Lee Memorial off the agenda.
A recorded broadcast of the meeting is posted on the Florida Channel. The commission is scheduled to meet again Dec. 1 in Tallahassee.
Connect with this reporter: @FrankGluck (Twitter)