That's particularly true in south Florida, he says, because of the fact that the market is made up mostly of small and medium-sized employers who don't have the clout to force insurers to resist rising prices.
"When I look at rising cost of insurance for our organization and employees, it's alarming because a major component of price rises has been the consolidation of the hospital industry," he says. "What's occurred is we have many large hospital systems that are using that size to leverage insurance companies for much higher rates. They would like you to believe it's to improve operations, but it's really to drive pricing leverage."
Reimbursement rates for commercial insurers aren't the only place Sonenreich feels like his standalone academic medical center—a 672-licensed-bed hospital with four satellite centers that reported 2012 net revenues of $550 million—can make a difference. Similar "gag" clauses are embedded in contracts hospitals and health systems have with medical device suppliers.
"It makes no sense that vendors are able to charge different hospitals different rates for the same products," he says. "We want the playing field to be leveled. We meet the quality of others, so it's not fair that we should receive 40% less reimbursement for doing the same things others are doing. That makes it very difficult for us to grow our mission."