Cost Analysis for Florida Ambulance Services

May 01, 2017

FAIR Health continues to work with a number of state agencies on a variety of transparency and other policy initiatives. For example, the office of Florida’s Insurance Consumer Advocate recently requested our assistance in examining the cost and utilization of ambulance transportation–a topic of growing concern for payors nationwide. This project was a return engagement. FAIR Health made our first presentation at the invitation of Consumer Advocate Sha’Ron James at a public hearing in Tallahassee over a year ago. We have provided additional data and analysis on a variety of subjects to the state in the interim.

FAIR Health President Robin Gelburd was invited to make her recent presentation to a Florida Department of Financial Services work group on trends in ground ambulance experience. This session, held February 28, 2017, was broadcast throughout Florida over television station WSFU-TV. After providing information about FAIR Health’s origin and mission, and explaining the way our claims data are received, validated and made available for stakeholder use, Ms. Gelburd addressed the Commission’s request to examine trends in ground ambulance utilization and pricing. Her report included trends for Florida as a whole, for 23 geographic regions in Florida and for certain larger metropolitan regions within the state (e.g., Miami, Tampa). Ms. Gelburd also presented a comparison of Florida’s recent experience to that of other states—specifically, Georgia, Texas and New York. The analysis included claims volume, average charge, most common charge, allowed amount and Medicare values. Later this year, FAIR Health will assist the group as it studies air ambulance rates.

FAIR Health is uniquely qualified to report on state-level healthcare service utilization because of the vast number of geographically specific claims contained in our repository. For example, in the case of Florida, FAIR Health maintains approximately 1.1 billion claims for medical, dental and facility services in Florida dating back to 2002; we received approximately 104 million Florida claims in 2015 alone, the most recent year for which we have final numbers. The fact that the data are organized geographically makes them especially valuable for a variety of studies.

Ms. Gelburd stated, “FAIR Health welcomes the opportunity to analyze our claims data in collaboration with states and other entities to further their efforts to improve healthcare delivery and address costs. We share a common goal of making transparent, actionable healthcare cost information available to all healthcare sector stakeholders.”