Diagnosis for 6.23.25: Checking the pulse of Florida health care news and policy

Welcome back to Diagnosis, a vertical that focuses on the crossroads of health care policy and politics.

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— Sticker shock —

The financial toll of opioid use disorder in the U.S. reaches an estimated $934 billion per year, according to a report by Avalere Health. That figure includes lost productivity, health insurance and uninsured care costs, substance use treatment, and criminal justice expenses.

The report found total annual costs related to OUD to be $934 billion nationwide, with most of that, $438 billion, coming from lost employer productivity, followed by employee productivity, at $248 billion.

OUD costs $111 billion annually in health insurance and uninsured costs, as well as $73 billion in lost household productivity. Other costs include criminal justice ($52 billion) and substance use treatment ($12 billion).

The report emphasizes that access to effective treatment can significantly reduce these costs. Behavioral therapy alone can save up to $144,000 per case. When combined with long-acting injectable buprenorphine, savings rise to $295,000 — pairing behavioral therapy with methadone or sublingual buprenorphine results in savings of up to $271,000 per case.

Roughly 6.1 million people reported having OUD in 2022. Defined as chronic opioid use causing significant distress or impairment, OUD is also linked to higher rates of financially motivated and violent crime, rates that decrease with effective treatment.

Despite these benefits, barriers to care persist. These include provider stigma, insufficient training, geographic challenges, and the social stigma associated with seeking treatment.

In Florida, OUD costs state and local governments between $200 and $299 per capita, which is comparable to about half the country. West Virginia faces the highest per capita cost, exceeding $500 per person.

For context, the Centers for Disease Control and Prevention estimates the combined economic impact of heart disease and stroke at $422 billion, significantly less than even conservative estimates for OUD.

Avalere’s research drew from targeted literature and modeled OUD costs across outpatient care, including impacts on government, businesses, individuals, and broader society.

The report’s research and writing team includes Margaret Scott as the principal, research scientist Tim Collins, senior associate Gina Krupp, associate Amanda Sitkowski, managing director Michael Ciarametaro, and associate principal Chani Seals.

— Three in a row —

Tampa General Hospital has been named to Becker’s Hospital Review’s list of “52 Hospitals and Health Systems with Great Innovation Programs” for the third year in a row. It is one of just four Florida-based systems — and the only academic health system in the state — to make this year’s list.

The annual list recognizes hospitals leading in the development and deployment of innovative strategies to enhance patient care, improve operations, and address health care’s evolving challenges. Tampa General was highlighted for its investment in cutting-edge technologies, strategic partnerships, and efforts to embed innovation into the organization’s culture.

“At Tampa General, we view innovation as a strategic imperative,” said John Couris, president and CEO of Tampa General. “Our team has doubled down on investments in technology and partnerships to drive transformative change that benefits our patients, our community, and the broader health care landscape.”

Scott Arnold, executive vice president and chief digital and innovation officer, added, “The pace of technological advancement in health care is accelerating, and we’re committed to identifying the right solutions and scaling them to deliver meaningful impact.”

Becker’s Hospital Review is a leading source of hospital business news and analysis for the health care industry. Tampa General and the complete list of this year’s “52 Hospitals and Health Systems with Great Innovation Programs” are profiled online here.

— Significant savings —

Gov. Ron DeSantis signed a bill that establishes compensation limits for health care services provided to inmates who are housed in Martin County detention centers.

Palm City Republican Rep. John Snyder sponsored the measure (HB 4007), which was a local bill that passed unanimously out of the Martin County Delegation.

The legislation focuses on compensation for health care services by setting specific payment caps for providers and emergency medical transportation services based on Medicare-allowable rates.

The bill was designed to ensure that costs remain controlled, while still maintaining access to medical care for inmates. The act came into effect upon becoming law.

Compensation would be limited for health care providers who offer medical services to inmates, with payments capped at 110% of the Medicare-allowable rate. If a health care provider had a negative operating margin the previous year, they would be able to claim 125%.

For hospitals designated as trauma centers, compensation is set at 175% of the Medicare-allowable rate for trauma alert victims. Compensation for emergency medical transportation, which includes ambulances or air ambulances, would be limited to 110% of the Medicare-allowable rate if the provider lacks a contract with the county.

However, medical services provided at Martin County-operated hospitals would be excluded from these compensation limits.

During the bill’s passage through its last committee stop with the House State Affairs Committee, West Palm Beach Republican Rep. Mike Caruso said a similar measure had been implemented in another county, and the cost savings were already being noticed.

“I know that in Port St. Lucie, this took place a couple of years ago,” Caruso said. “They’re saving about a million dollars a month. Martin County will probably do the same, only wish we had done it in Palm Beach County. Looking forward to carrying this bill next year in Palm Beach County.”

— Vital funding —

With Sine Die in the rearview, Florida’s Safety Net Hospitals are applauding lawmakers for directing money to institutions providing complex, lifesaving care to Florida’s most vulnerable.

The Safety Net Hospital Alliance of Florida represents numerous nonprofit institutions and health care systems across the state that serve a high volume of Medicaid patients and provide an outsized share of uncompensated care.

“Safety Net Hospitals are Florida’s premier public hospitals, academic medical centers, and children’s hospitals, including Florida’s most advanced perinatal intensive care centers,” said Safety Net Hospitals CEO Justin Senior. “We’re grateful the Legislature recognized how vital it is to protect funding for hospitals that deliver complex care to Floridians, especially our vulnerable residents with serious medical needs.”

He continued, “This budget allows Safety Nets to provide the most advanced lifesaving procedures, primary care, and prevention services to all communities across our great state, while shouldering the highest volumes of Medicaid and charity care in the state.”

The Alliance also praised lawmakers for continuing to invest in the state’s medical workforce pipeline, with Senior touting recently released data showing Safety Net Alliance members beating statewide and national averages in Match Rates — a measurement of hospitals’ success in filling their empty residency slots.

“By funding graduate medical education, lawmakers are ensuring Florida has a strong pipeline of well-trained doctors who are more likely to stay and practice here after residency. Supporting our teaching hospitals is one of the smartest investments Florida can make to provide world-class care now and into the future,” Senior said.

Safety Net Hospital Alliance members include UF Health, Jackson Health, Ascension Florida, Broward Health, Halifax Health, Johns Hopkins All Children’s Hospital, Lee Health, Memorial Healthcare System, Mount Sinai Medical Center, Nicklaus Children’s Hospital, Orlando Health, Sarasota Memorial Health Care System and Tampa General Hospital.

 — ICYMI —

“Hidden charges? Patients often face massive bills when Florida hospitals don’t provide costs up front” via Cindy Krischer Goodman of the South Florida Sun-Sentinel — For Floridians, knowing how much a procedure costs before getting hit with a humongous hospital bill can be the difference in whether someone struggles for years with medical debt. Now, Florida’s Attorney General James Uthmeier announced he is launching an investigation to ensure hospitals provide patients with transparent pricing for medical services. Florida hospitals are supposed to make it easy for patients to know the costs up front and compare prices. However, it is not happening in the way federal and state laws require. Try to compare the cost of a chest X-ray or colonoscopy at hospitals anywhere in the state and you will discover that many fail to provide clear and accessible pricing information on their websites.

“The price you pay for an Obamacare plan could surge next year in Florida” via Daniel Chang for the Miami Herald — Millions of Americans, like Miami caregiver Josefina Muralles, may lose their affordable health insurance as enhanced pandemic-era subsidies for the Affordable Care Act (ACA) are set to expire at the end of the year. Without congressional action, enrollees face massive premium hikes, with states like Florida and Texas hit hardest. The issue has sparked a political debate: advocates warn that millions could become uninsured, while critics argue that the subsidies were temporary measures that inflate costs and encourage fraud. Insurers are urging a decision before the Fall open enrollment period to prevent widespread confusion, leaving millions of working families uncertain about whether they will be able to afford their health coverage next year.

“Judge orders NIH to restore research grants related to diversity” via Joanna Slater and Danielle Douglas-Gabriel of The Washington Post — A federal judge in Massachusetts on Monday ordered the Trump administration to restore hundreds of scientific research grants terminated by the National Institutes of Health, saying the funding cancellations were illegal and discriminatory, two lawyers in the case said. The funding cuts targeted research connected to topics such as race and gender identity. “We are really gratified that we have a judge who has taken a fair look at the record and come to the very clear conclusion that NIH and the defendants have acted unlawfully in terminating these grants based on ideological grounds and not based on science,” said Shalini Goel Agarwal, special counsel at Protect Democracy, an advocacy group representing the plaintiffs in one of the cases.

“Cap reax: Florida Hospital Association applauds ‘meaningful health care investments’ in budget” via Jesse Scheckner of Florida Politics — Count the Florida Hospital Association (FHA) among the organizations praising lawmakers for considerations in the state’s 2025-26 spending plan. The Tallahassee-headquartered nonprofit trade group, which represents hospitals and health systems across the Sunshine State, applauded the Legislature for making “strategic investments in health care,” prioritizing research, infrastructure, mitigation grants and expanded patient access. That includes: $15 million to support hospitals performing intestinal transplants and $10 million for the Cancer Connect Collaborative incubator lawmakers created this year to advance pediatric cancer care and treatment research by specialty children’s hospitals.

“MFN policies are not the answer for Florida patients” via Michelle Flowers for Florida Politics — My career in oncology has given me a front-row seat to the challenges patients face. That is why it’s so difficult to see lawmakers like Sen. Scott push for the “Most Favored Nation” pricing model. While it may sound promising, MFN is a harmful, one-size-fits-all approach that would tie our drug prices to foreign countries where patients have fewer treatment options and longer delays. This would reduce the quality of care for Florida’s most vulnerable on Medicare and Medicaid and stifle the innovation we need for new cures. Rather than importing flawed foreign policies, we must reform our own system by addressing programs like 340B and Pharmacy Benefit Managers (PBMs). I urge our leaders to oppose MFN.

“Republican’s life-threatening pregnancy collided with Florida’s abortion politics” via Katy Stech Ferek of The Wall Street Journal — Republican Rep. Kat Cammack, a co-Chair of the House Pro-Life Caucus, revealed a terrifying experience where doctors delayed lifesaving treatment for her ectopic pregnancy due to fear over Florida’s new six-week abortion ban. Despite the nonviable pregnancy threatening her life, Cammack said she had to argue for hours before staff administered the necessary medication. She blames “fearmongering” by the left for the medical team’s hesitation, not the restrictive law itself, a claim abortion-rights advocates dispute, arguing the law created the dangerous confusion. Now pregnant again, Cammack is sharing her story, hoping to bridge the political divide and foster a better dialogue on women’s health care, even as her experience highlights the law’s chaotic real-world consequences.

 — RULES —

The Board of Acupuncture’s final rule regarding documentation necessary for licensure application (64B1-4.0011) goes into effect July 1. More here.

The Board of Speech-Language Pathology and Audiology’s final rule regarding educational requirements for licensure (64B20-2.002) goes into effect July 1. More here.

The Board of Hearing Aid Specialists’ final rule licensure by examination (64B6-2.003) goes into effect July 1. More here.

 — PENCIL IT IN —

June 25

Happy birthday to Sen. Bryan Avila.

June 26

Happy birthday to First Lady Casey DeSantis, Rep. Dianne Hart and Rep. Lawrence McClure.

June 27

Happy birthday to Senate Democratic Leader Lori Berman.

June 30

Happy birthday to Sen. Erin Grall.

July 4

Happy birthday to Rep. Randy Maggard and Rep. Tiffany Esposito.