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Some Florida urgent-care clinics will be required to post prices for common procedures

State Rep. Richard Corcoran recalled a day last year when a doctor recommended an MRI test for his wife's back pain.

When they asked how much it would cost, "nobody knew," Corcoran said. "No one would tell me."

They called around, and found that the price of an MRI varied from $350 to $1,200.

That experience was a driving force behind the health care price transparency bill that the New Port Richey Republican introduced this year. It was approved overwhelmingly and takes effect on Friday.

Urgent care clinics across the state will be required to post on 15-square-foot signs the prices of their 50 most frequently provided services. Those that don't face fines of up to $1,000 a day until they comply.

Corcoran sees the law as a first step toward making the often-mysterious and varied prices of health care services more available to patients. It comes at a time when patients are paying a greater share of their health costs, either because they are uninsured or are covered by high-deductible plans. That's the kind of insurance Corcoran had as the owner of a small business, before he was elected to the state House last fall.

"When you're paying the first $10,000 out of pocket, the first thing you ask is, what's the cost?" he said.

Many doctors, however, say that health care pricing is too complex for fast-food-style pricing. With thousands of billing codes and so many ways to pay, including cash, private insurance and government programs such as Medicare and Medicaid, posting a single price could be more misleading than helpful.

"It's very well-intentioned," said Rep. Ronald Renuart, R-Ponte Vedra Beach, who's a physician. "But the law isn't as straightforward as it seems."

Corcoran argues that such price transparency already exists in the state, at private urgent-care clinics like Solantic, a chain previously owned by Florida Gov. Rick Scott, and MedExpress, which has several locations in the Tampa Bay area. So he crafted legislation based largely on what those clinics have been doing.

The posted prices will apply only to patients who are paying cash for services, not those using insurance. The law applies to urgent-care clinics, but not facilities such as hospital emergency rooms. Individual primary care physicians aren't required to post prices, but if they do so voluntarily, they don't have to pay license fees and fulfill continuing medical education requirements for a period of time.

• • •

The law has drawn a mixed reaction. Consumer and business groups such as Florida Public Interest Research Group and Associated Industries of Florida supported the legislation.

But doctors have been less enthusiastic. When details were presented at a recent meeting of the Pinellas County Medical Association, the news was greeted with a collective groan. Doctors wanted to know more about the requirements and which types of practices they applied to.

Renuart says there are good reasons for their concern.

It's still unclear exactly which clinics must comply. Besides urgent care centers, there's still a question of whether any clinic that accepts walk-in patients must post prices as well. Corcoran said the state Agency for Health Care Administration is in the process of determining that.

Renuart said that the prices could create confusion because they only apply to patients who pay by cash or debit or credit cards. He said the majority of patients at many clinics are covered by some type of insurance.

He also offered this possibility: that seeing the prices might give some patients sticker shock. "You don't want to drive away patients who need care," Renuart said.

Further, he said waiving continuing medical education requirements could be no incentive at all, since many physicians need to meet them to remain board certified. These courses help physicians stay on top of new information about medications and treatments that benefit patients, he noted.

Both Renuart and Corcoran expect that the number of primary care physicians who post their prices voluntarily will be low. Renuart, who works for Baptist Primary Care, a large physician network covering northeast Florida and Southern Georgia, said he isn't likely to do so.

• • •

Urgent care clinic operators around Tampa Bay have been working to meet the Friday deadline. Among them are Morton Plant Mease, which has clinics in Trinity and Largo, and Bayfront Medical Center, which has six clinics in Pinellas County.

Morton Plant's clinics will include prices for a standard office visit, X-rays, vaccines, school physicals and laboratory tests, said Kevin Corrigan, chief operating officer of Morton Plant Mease Primary Care. He said the list may change quarterly, based on the most frequently provided services.

Bayfront clinics will go beyond the required 50 services and list about 90 of them, said Phil Powell, executive director of the clinics. He said part of the reason is that Bayfront officials believe their prices are competitive with what other clinics charge.

"I think any time consumers get more information, it's going to be a good thing," he said.

Among the prices patients are likely to see at Bayfront's clinics: school physicals ($30); routine office visit ($75); chest X-ray ($130).

The clinic also has a flat rate of $17 for any medication it dispenses. "Patients may be able to get it for less or more elsewhere, but we make it simple," Powell said.

Corcoran would like to expand the pricing requirement to more physicians and clinics in the future. He added that lawmakers in Oklahoma have contacted him, interested in passing a similar bill there.

"I see it as a first step toward creating a real free market in health care, where you have the greatest quality of care at the lowest cost to the consumer," he said.

Richard Martin can be reached at rmartin@sptimes.com or (813) 226-3322.

Some Florida urgent-care clinics will be required to post prices for common procedures 06/26/11 [Last modified: Monday, June 27, 2011 8:54am]
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