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ACEP Cries Foul on Florida Price Transparency Effort

By Gregory A. Freeman  
   February 06, 2017

The American College of Emergency Physicians objects to the Florida Agency for Health Care Administration's partnership with a group that ACEP says is tied too closely to insurers.

Florida's effort to create a consumer website that would help people shop for healthcare services by price has hit a snag, with physician groups saying the site is being developed by a group that is too closely affiliated with health plans. That relationship with insurers will make the website a less objective and dependable tool for consumers, they say.

The Florida College of Emergency Physicians (FCEP) and its national organization, the American College of Emergency Physicians (ACEP), reacted strongly when the state awarded the website development contract to The Health Care Cost Institute (HCCI), which is sponsored by four of the country's largest health insurance companies. HCCI lists Aetna, Humana, Kaiser Permanente, and UnitedHealthcare as its data contributors.

HCCI describes its missions as "to promote independent research and analyses on the causes of rising U.S. health spending, to provide policymakers, consumers, and researchers with better, more transparent information on what is driving health care costs."

ACEP and FCEP, however, said the Florida Agency for Health Care Administration's partnership with HCCI goes against the goal of creating an independent and transparent web tool, and their financial relationship with insurers raises concerns about their objectivity and validity of their data.

"The HCCI data come from the health insurance industry, and there is no transparency or independence," said Jay Falk, MD, president of FCEP.

Falk noted that there were other contenders for the contract that would have been better choices, including Fair Health, which he called an independent, unbiased source of healthcare cost information. Fair Health has been recognized for its independence and transparency by Kiplinger's Personal Finance as the "Best healthcare cost estimator" in 2016.

The Fair Health claims database was developed after United Healthcare was successfully sued by the State of New York for fraudulently calculating and significantly underpaying doctors for out-of-network medical services, using the Ingenix database, Falk said. The formula used forced patients to overpay up to 30% for out-of-network doctors.

Gregory A. Freeman is a contributing writer for HealthLeaders.

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