Florida health plan rates are among the lowest in the U.S.
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.
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