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South Florida Hospital Experiments With New Transparency Tool


Health care prices are notoriously difficult to come by ahead of a procedure, but Jackson Health System in South Florida is experimenting with a new approach in price transparency.

Hospitals keep a list of what they charge for health care services—but if you have insurance, that charge may have nothing to do with what your insurance company has negotiated and what your out-of-pocket expenses would be.

What makes Jackson’s Care Quote different from a typical estimate is how it accounts for an individual’s insurance plan.

Here’s how it works: Potential patients call a number or fill out an online form with their insurance information. They tell Jackson what they’re looking to have done. And then Jackson staff basically run those details through the same process that gets used for billing.

“The insurance companies are holding patients responsible for a larger portion of the care… and the patient has options, they can shop around,” says Myriam Torres, vice president of revenue cycle for Jackson. She says the Care Quote tool satisfies new price transparency regulations. And it comes at a time when patients are asking more questions about what their care may cost.

The tool does not let shoppers compare what the same procedure might cost under different insurance providers or at different hospitals. And for now, it reflects the facility fees, but not the physician fees.

Most of the quotes requested so far have been for maternity care and expensive imaging services like MRIs and CT scans.

“Cost of those services tend to have a higher out-of-pocket than some of your normal, general services,” says Telisa Lyons, corporate director of patient access at Jackson.

Jackson administrators hope the tool will attract more price-conscious patients with insurance.

This story is part of our PriceCheck project. Next Monday, WLRN’s Sammy Mack and Tom Hudson will focus on health care price transparency on a special edition of the Sunshine Economy. 

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