At a hearing to discuss the rising costs of healthcare benefits for Miami-Dade County employees this year, a labor union consultant raised his hand to ask what seemed like a basic question.
Could the committee charged with reducing Miami-Dade labor’s healthcare expenses look at the spreadsheet showing the rates that the county pays local hospitals and doctors for medical services to employees?
“We really need to understand where the money is being spent in order to be insightful about benefit design changes,’’ said Duane Fitch, a healthcare consultant for SEIU Local 1991, which represents physicians and nurses at the county-owned Jackson Health System.
But the answer to Fitch’s question at that inaugural meeting of the Miami-Dade Labor Healthcare Committee last March was the same response he would receive every time he repeated the question during the panel’s next six meetings through July.
“Contracts are proprietary,” said Patricia Nelson, regional head of strategic accounts for AvMed Health Plans, the county’s health benefits administrator that negotiated the payment rates for medical services for county employees. She noted that both the insurance company and the healthcare providers agree to keep such payment rates confidential.
Fitch and others who asked for the information never got to see precisely how Miami-Dade spends more than $400 million a year to pay healthcare claims for nearly 60,000 employees, retirees and dependents in the health plan.
That’s because Miami-Dade — like many employers across the country — isn’t allowed to know the prices their own insurance plan administrators negotiate with healthcare providers, even when they’re self-insured, like Miami-Dade County, and the claims are paid with taxpayer dollars.