Insurers shun state healthcare website
Friday, September 28, 2018
Posted by: DCMS
The News Service of Florida
By Christine Sexton
TALLAHASSEE --- The pushback against Gov. Rick Scott’s effort to create a health-care transparency website appears to be more widespread than state officials previously acknowledged.
Members of a statewide advisory panel were told this week that the Agency for Health Care Administration is “in the process of working with” insurance giant Florida Blue on getting claims data to use for the long-promised website that is supposed to help consumers compare health-care prices.
But the State Consumer Health Information and Advisory Panel wasn't told that other companies aren’t supplying the claims data that the site will rely on.
AvMed, a Florida-based health maintenance organization, also is not submitting the information to the state, AHCA spokesperson Mallory McManus said.
The companies that have refused to cooperate with the state have cited privacy and trade-secret concerns about sharing the information with the contractor responsible for creating the website.
McManus told The News Service of Florida that Florida Blue and AvMed were the only companies withholding the information.
But Toni Woods, a spokeswoman for Florida Blue, said the “last time we checked” other companies affiliated with the insurance carrier --- such as Health Options, the largest HMO in the state, and Capital Health Plan, a popular Tallahassee-based HMO --- aren't submitting the data, either. And, according to Woods, neither is another affiliated company, the Daytona Beach-based Florida Health Care Plan.
Florida Blue and Health Options are the state’s top two health-care companies, providing coverage to nearly 1.4 million individuals in 2016.
In all, the companies not reporting the information provided coverage to more than 1.5 million people in 2016, according to a state insurance report.
Members of the advisory panel were given a brief update on the Florida Health PriceFinder website at a five-hour meeting in Gainesville earlier this week. When completed, the website is supposed to give consumers access to faciliity-specific payment information on an array of health-care services.
Information about the Florida HealthPriceFinder website was part of a larger presentation about its sister site, Florida HealthFinder, where viewers can obtain information about items such as health-care facilities and licensure.
During Wednesday’s meeting, AHCA staff briefly mentioned that the HealthPriceFinder website had received 29,457 visits, then advanced to the next agenda item.
But Kim Streit, who chairs the council, asked the agency whether insurance giant Florida Blue was submitting the data as required.
Panel members were told by advisory council staff that the state is in the process of working with Florida Blue on data submission.
Streit, an executive at the Florida Hospital Association, then asked whether the agency had a new timeframe for the official launch of the website, which was supposed to be finalized months ago.
AHCA staff said the agency is holding weekly meetings with the health plans regarding the data submission, but the state doesn’t have a timeline for the launch.
“So it won’t be next week?” Streit asked.
The price finder website was one of Scott's key health-care initiatives. The governor championed increased health-care transparency in 2016, a year after a bruising legislative battle over expanding Medicaid access for uninsured, childless adults.
In lieu of expanding Medicaid, Scott said he would help uninsured Floridians by working to lower the cost of health care and touted increased transparency as a key way to do that.
Scott, who is seeking to unseat U.S. Sen. Bill Nelson, leaves office in early January.
The state contracted with the Health Care Cost Institute, or HCCI, to administer the database and develop a consumer-friendly website. HCCI was founded in 2011 by four insurance companies, including Aetna, Humana, and UnitedHealthcare --- all of which write coverage in Florida and have voluntarily submitted the claims.
But other carriers haven’t reported the data because they haven’t been required to do so until this year.
While the health plans may not be submitting the data, the state agency continues to work with them and "all stakeholders," AHCA's McManus said.
"Our website is being updated and worked on every day," she said.
HCCI has extrapolated the data it collects to develop hospital-specific information showing the average costs insurance companies paid for certain services.
But the preliminary website included glaring errors because HCCI lacked claims data from Florida Blue, Health Options and others. That prompted the FHA to ask the state to delay the public launch until the data issues were resolved.
At Wednesday’s meeting, AHCA staff never told Streit or other panel members that other companies weren’t submitting the data.
Streit, who half-jokingly said she had been checking the agency’s website to see if the information had been posted, thanked the agency for its continued efforts on the website.
“Worst thing we could do is put out data from this group that is misleading,” Streit said.