Florida hospitals and health plans both sang the praises of a new state law signed last week by Gov. Jeb Bush, although they weren't always singing from the same hymn book.
The law requires hospitals and ambulatory surgery centers to provide pricing and outcomes data for public review; creates a public agency to help providers improve patient safety; and provides more lower-cost health insurance options for small employers and high-risk individuals.
Insurers are happy with the first part. Florida hospitals have been reporting significant financial and quality data to the state for 25 years, but it has been published in a way that is very confusing to patients, said Bill Bell, general counsel of the Florida Hospital Association.
Health plans say putting this information in a form that patients understand may slow rising hospital prices, said Karen Ignagni, president and chief executive officer of America's Health Insurance Plans, the lobbying group formed by the merger of the American Association of Health Plans and the Health Insurance Association of America.
Ignagni, in an interview at Modern Healthcare's Chicago office, said hospital prices in Florida could be restrained in the same way that publishing drug pricing information has helped control drug prices. "When it's out in the public, the prices move, when consumers get more information," Ignagni said. "I think this is the beginning of a far greater movement toward transparency."
Bell said he didn't think the pricing disclosure would have much effect on the balance between payers and providers because sophisticated payers understand the old form of disclosure and had incorporated that information into their bargaining.
Hospitals and health plans applauded the provisions that allow health plans more flexibility in defining benefit packages and that address patient safety.
The insurance provisions might be the most significant aspects of the law to Florida hospitals. "It's the most important set of reforms in health insurance in the last decade," said Ralph Glatfelter, senior vice president of the Florida association. The law creates purchasing pools to make insurance more affordable for small employers and promotes more flexible insurance products, such as health savings and health reimbursement accounts. The law also creates a state health plan for high-risk individuals who can't otherwise get coverage.
"We hope it's going to provide sufficient flexibility" to keep employers from dropping coverage, encourage small companies to add benefits and enable some of Florida's 2.8 million un-insured to find health insurance, Glatfelter said.
Hospitals also welcome a provision that emphasizes the state's insurance regulations that require health plans to make arrangements for their members to receive care 24 hours a day, seven days a week without flooding hospital emergency rooms, Glatfelter said.
The law also establishes a Florida Patient Safety Corp., designed to analyze medical errors and determine whether those errors are preventable. The corporation won't punish providers, but it will focus on educating them on best practices and error prevention, Bell said. Insurers support the promotion of best practices, Ignagni said, although there are concerns that separate state efforts could lead to differences in the way care is provided based on geography rather than medical science. AHIP members favor a national effort in this area, she said.
The law also requires the Florida Agency for Health Care Administration to develop a strategy to promote electronic medical records, but the law does not authorize any money to pay for adoption of an EMR. "It's an objective that I think most hospitals would like to see accomplished," Glatfelter said. "The issue is, of course, how do you pay for it?"