Quarterly SCHIP Advisory Council Meeting Florida Price Transparency

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Quarterly SCHIP Advisory Council Meeting Florida Price Transparency Initiative HCCI March 28, 2018 1

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

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:

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

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.

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 Easily accessible from Florida. Health. Finder. gov 6

Post Rule Website: Highlights cont. Three Search Options to Find a Care Bundle of

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

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

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

Post Rule Website: Highlights cont. Commercial Price Data Set and Care Bundle Details Documentation 10

Post Rule Website: Highlights cont. Consumer Survey 11

Post Rule Website: Highlights cont. Consumer Survey 11

Website Demo 12

Website Demo 12

Example of Commercial Price Data Set 13

Example of Commercial Price Data Set 13

Example of Care Bundle Details Document Knee Replacement A Care Path ID Step ID

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

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

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

Questions? 17