Are Florida’s Hospitals Price Gouging Patients?
VA Medical Center in West Palm Beach, Florida. Thomas Barrat / Shutterstock.com
The Sunshine State’s governor thinks so, and he’s pushing cost transparency legislation to inform patients’ healthcare decisions.
Florida Gov. Rick Scott, a former hospital CEO, is supporting efforts to target hospital “price gouging” with legislation in the 2016 session that would require medical facilities to post pricing information, average payments and annual IRS reports prominently on their websites.
In his announcement on Monday, the governor said he’s also seeking to allow patients to refer suspected hospital price gouging to the proper law enforcement and regulatory authorities.
Scott’s announcement came as his recently created Commission on Healthcare and Hospital Funding met in Tampa and heard from Andrea Caballero, Catalyst for Payment Reform program director, whose organization gave Florida and 44 other states an “F” on its 2015 cost transparency report card.
“The high cost of healthcare continues to hurt some of our most vulnerable families in Florida, and the best way to guard against unfairly high hospital costs being passed on to patients is to require hospitals to be fully transparent with their own costs and patient charges,” Scott said in his announcement. “Most Florida hospitals receive state taxpayer dollars. We must not use state money to subsidize hospitals who are charging our citizens unfairly high prices for services they receive, often during a time of personal crisis.”
With the institutions clamoring for Medicaid expansion to hundreds of thousands of Floridians under President Obama’s Affordable Care Act, Scott has painted hospitals—particularly those receiving some of the $400 million in taxpayer dollars doled out to offset heavy federal funding reductions—as cash flush.
Publicly funded and government-owned hospitals should be held to the same transparency standards as private hospitals, Scott said, starting with an update to FloridaHealthFinder.gov allowing consumers to estimate their out-of-pocket expenses in advance.
The federal government already releases data on hospital pricing of common surgeries, and Scott’s critics accused him of pre-empting of his own commission’s transparency recommendations.
“It seems less about policy and more about about politics,” Bruce Rueben, Florida Hospital Association president, told the Palm Beach Post. “The idea of price transparency is one we’re supporting, but it’s unnecessary and very discouraging to put this in the form of unfounded accusations.”
Rueben also told FlaglerLive his association is working on its own hospital transparency legislation and that “there’s a big difference between high prices and so-called price gouging.”
But that doesn’t change the fact 20 of the 50 U.S. hospitals with the highest markups are in Florida, according to a June Health Affairs study.
Any hospital price transparency initiative should provide decisionmakers with timely, accessible and actionable information, per CPR’s report card:
While legal barriers hindered initial efforts to promote price transparency, states can address many of these barriers through legislation and litigation. Legislation can prohibit clauses in provider-insurer contracts that would obscure health care prices, as well as ensure that trade secret protection is not used in ways that harm the public interest.
Is additional hospital reform legislation on the horizon in Florida?
Scott has blamed hospitals’ high insurance rate charges for depriving Florida’s new Medicaid privatization program of funds, as well as floated the idea of eliminating the entrenched “certificate of need” process for state approval of new hospitals or their expansions.
“A publicly available financial disclosure will ensure that we know where taxpayer money is going and if it is being used to provide patients hospital services or fund record-high hospital profits and CEO bonuses,” he said in his statement. “I look forward to working with the Legislature in the upcoming session to make reforms that will allow patients to see what revenues hospitals are collecting and what they are billing patients for medical procedures.”
Scott’s complete announcement can be read here.
(Photo by Thomas Barrat / Shutterstock.com)
Dave Nyczepir is a News Editor for Government Executive’s Route Fifty.
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