Florida health plan rates are among the lowest in the U.S.
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One of the first national studies of publicly available health insurer price data found some of the lowest rates for office visits and medical procedures in Florida.
Why it matters: The findings published in JAMA Health Forum could help shine a light on regional price variations and whether higher costs translate to more value in markets, Axios' Maya Goldman writes.
- That, in turn, could help employers, providers and patients make more informed choices and manage health care costs.
The big picture: More than half of the state's population receives health insurance from private health plans, and prices are negotiated with providers instead of set administratively, like in Medicare.
- 40% of Floridians receive health care coverage through an employer, while about 10% are covered by a policy purchased directly from an insurance company, per the Kaiser Family Foundation.
Details: The researchers looked at Humana's negotiated rates for seven procedures, including colonoscopies, patient office visits and high-severity emergency department visits, as of October 2022.
By the numbers: Citrus, Pinellas and Sarasota counties had the lowest rates for office visits and medical procedures in Tampa Bay, with prices between $71 and $75.
- Prices for established patient office visits in Pasco, Hernando, Polk and Manatee counties were a bit higher, ranging from about $75 to $80, according to the study.
- Hillsborough County had the highest rate for an office visit in Tampa Bay at around $85 to $89. That figure is still lower than scores of other counties across the U.S. — where prices stretch from $90 to over $500.
Yes, but: Overall, the prices commercial health insurers pay to hospitals and physicians have been rising quickly, the nonpartisan Congressional Budget Office found last year.
- John Couris, Tampa General Hospital's chief executive, told Axios in August that the biggest health care issue Tampa Bay faces "is not access or convenience, it's cost."
- Florida also has the fifth-largest uninsured population in the country.