Creating opaqueness to health care costs

Creating opaqueness to health care costs

Florida health care regulators now say that a much-promised website to help residents shop for health care will have specific information about what individual facilities charge by this fall.

The site has had limited value because state officials have had trouble getting claims data. But that has changed, and Agency for Health Care Administration spokesman Patrick Manderfield said the state expects to have needed claims data by the end of June. That’s about three years after a bill took effect that gave the state the green light to collect the data and establish the website.

The Legislature approved the creation of what is known as an all-payer claims database in 2016, requiring companies that write coverage in the state employees’ health-insurance program or participate in the Medicaid managed-care program to submit claims data to the state’s vendor, Health Care Cost Institute. In addition to creating the database, lawmakers agreed to spend millions of dollars on it.

Moreover, Florida-based companies, including Florida Blue, had concerns over the privacy of sensitive information and ownership of the data. The concerns stemmed, in part, from the fact that Health Care Cost Institute, known as HCCI, was founded by three insurance companies, Humana, Aetna and UnitedHealthcare. The privacy and ownership issues were resolved, Florida Blue spokeswoman Toni Woods said, when AHCA “clarified that issuers remain owners of their own submitted data.”

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