Quarterly SCHIP Advisory Council Meeting Florida Price Transparency
- Slides: 17
Quarterly SCHIP Advisory Council Meeting Florida Price Transparency Initiative HCCI March 28, 2018 1
Outline § FL Transparency Initiative § Pre-Rule Site § Post Rule Site § Website Demo § Datasets § Next Steps 2
Florida. Health. Price. Finder (FHPF) § Project Kick Off: April 2017 § Website Development: June 2017 § Ingest FL Medicaid Data: July 1, 2017 § Pre-Rule MSA Website Launch: November 28, 2017 § Post-Rule Facility Website Launch: ~4 -6 weeks after the Rule is finalized § Onboard Florida Blue and Av. Med data once the Rule is finalized; this data will be displayed after the 2 nd release of the website (timing TBD) § Other payers’ data will be included in upcoming website releases 3
Pre & Post Rule Website Pre-Rule Website Post Rule Website Launched November 28, 2017 Estimated Launch early-mid May 2018 Co-branded site Data from Aetna, Humana, and United 24 month data period: 7/1/2013 – 6/30/2015; Trended to 7/1/17 24 month data period: 7/1/2014 – 6/30/2016; Trended to 7/1/18 National, State, MSA Level Prices National, State, County & Facility/Hospital Level Prices 295 Procedure Care Bundles 4
Accessing the FHPF Website § Users can access the website 3 different ways: 1. From Florida Health Finder - Access the site by clicking on the Florida. Health. Price. Finder link in the middle of the home page (http: //www. floridahealthfinder. gov/index. html) 2. From guroo. com – Change your location to a Florida city 3. From the new URL designated by Florida https: //pricing. floridahealthfinder. gov Note: The Pre-Rule website will be rendered until the Post Rule website is launched 5
Post Rule Website: Highlights Easily accessible from Florida. Health. Finder. gov 6
Post Rule Website: Highlights cont. Three Search Options to Find a Care Bundle of Interest 7
Post Rule Website: Highlights cont. Care Bundle Overview page displays Hospital and facility total prices along with other available geographic level prices for comparison 8
Post Rule Website: Highlights cont. Care Bundle Details page displays Hospital and facility steplevel prices along with other available geographic level prices for comparison 9
Post Rule Website: Highlights cont. Commercial Price Data Set and Care Bundle Details Documentation 10
Post Rule Website: Highlights cont. Consumer Survey 11
Website Demo 12
Example of Commercial Price Data Set 13
Example of Care Bundle Details Document Knee Replacement A Care Path ID Step ID Service Code Type Revenue Code Health Service Type Service Name Service Quantity/ Day(s) of Therapy Length of Stay (Inpatient) B AXB Unit Cost Example Total Cost TK 001 Step 1 99203 CPT Specialist Consultation Office Visit - New Patient - Moderate Complexity 1 $ 100 TK 001 Step 1 73560 CPT Radiology Services - Minor X-ray - Knee (1 or 2 Views) 1 $ 50 TK 001 Step 2 36415 CPT Laboratory Services Collection of Blood by Venipuncture 1 $ 5 TK 001 Step 2 85025 CPT Laboratory Services Complete Blood Count - CBC Test 1 $ 10 TK 001 Step 2 85610 CPT Laboratory Services PT Blood Test 1 $ 5 TK 001 Step 2 85730 CPT Laboratory Services PTT Blood Test 1 $ 10 TK 001 Step 2 86900 CPT Laboratory Services ABO Blood Typing Test 1 $ 5 TK 001 Step 2 86901 CPT Laboratory Services RH Blood Typing Test 1 $ 5 TK 001 Step 2 86850 CPT Laboratory Services Antibody Screening Blood Test 1 $ 15 TK 001 Step 2 00470 DRG Hospital Facility - Inpatient Major Joint Replacement 1 $ 30, 000 TK 001 Step 2 01402 CPT Anesthesia Services Anesthesia for Total Knee Replacement 1 $ 1, 500 TK 001 Step 2 27447 CPT Surgical Care Total Knee Replacement (TKR) 1 $ 2, 000 TK 001 Step 2 99223 CPT Physician Evaluation Initial Inpatient Physician Evaluation (High Complexity) 1 $ 250 TK 001 Step 2 99232 CPT Physician Evaluation Follow-Up Inpatient Physician Evaluation (Moderate Complexity) 3 $ 100 $ 300 TK 001 Step 3 97001 CPT Physical Therapy Evaluation 1 $ 75 TK 001 Step 3 97110 CPT Physical Therapy Exercises 12 $ 70 $ 840 TK 001 Step 3 97140 CPT Physical Therapy Massage and Traction 7 $ 50 $ 350 TK 001 Step 4 99213 CPT Specialist Consultation Office Visit - Established Patient - Moderate Complexity 2 $ 75 $ 150 TK 001 Step 4 73560 CPT Radiology Services - Minor X-ray - Knee (1 or 2 Views) 2 $ 50 $ 100 0120 4 TOTAL $35, 770 Step 1: An office visit with a specialist for a detailed evaluation and treatment of your symptoms Step 2: Inpatient surgery to replace a diseased or damaged knee joint with manmade parts Step 3: A guided physical therapy exercise program to reduce stiffness and improve range of motion in the knee Step 4: Two follow up office visits after you have left the hospital Trade secret, Confidential and Proprietary HCCI March 6, 2017 14
Requesting Care Bundle Details § To request the Care Bundle details, please send an email to: carebundledownloadfl@guroo. com § Requestors will need to sign a Request Form and acknowledge the Care Bundle License § The license will be sent along with the Request Form § Usage Requirements § Entity/Individual will use the Care Bundle Details document solely to further the purpose of, and in a manner consistent with, Florida’s Act Relating to Transparency in Health Care (2016 FL House Bill 1175) and the regulations that may be promulgated thereunder 15
Next Steps § Communications § Social Media § Education § Free Webinars § FAQS § Fact Sheets § Enhancements § Monitor feedback emails and Google Analytics § Suggestions via word-of-mouth 16
Questions? 17
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