Patients with high-deductible health plans are shopping around before they select an imaging provider -- and many may flee the higher costs of hospital-based departments in favor of independent facilities, according to an article published online November 9 in the Journal of the American College of Radiology.
Patients facing high deductibles shop around for imaging services, calling hospitals and private facilities and using internet resources to gather information about scan costs. But price quotes from hospitals can be misleading, due to list prices for services that often don't reflect discounts or insurance coverage, wrote a team led by Dr. David C. Levin of Thomas Jefferson University.
"As patients find themselves facing high deductibles, often between $3,000 and $7,000 and sometimes even higher, they will become increasingly price conscious, particularly when facing high-cost tests like MRI, CT, PET, and nuclear medicine examinations. ... Unfortunately, patients who engage in ... price shopping will frequently find not transparency but rather confusion, misinformation, and opaqueness," the group wrote. "This poses a threat to some radiology practices, especially those that are hospital-based."
When patients call their hospital for a quote, the hospital's list price for the service often does not reflect the actual payment for which a patient will be responsible (which can be much less), and patients may also get inaccurate information from hospital staff. What's more, websites tend to get their data by contacting hospitals or imaging facilities, running into the same problem.
"The individual who answers the phone [at the hospital] may be a scheduler, a receptionist, or clerk in the radiology department," the group wrote. "He or she may not be aware of the different types of prices offered by the facility for the imaging study and might quote a price without defining what it actually represents."
So how can hospitals and their radiologists provide patients with accurate pricing information? Levin and colleagues made two suggestions:
- Hospital staff can direct patients to their insurer for a better indication of what they will owe, based on what the insurer would pay if the deductible were already met.
- Hospitals should consider lowering their list prices for imaging. "It may not be easy for hospital-based radiologists to convince their institutional administrations to do so, but the present situation could result in hospital radiology departments pricing themselves out of the market," the team wrote.
A lack of price transparency for imaging services is a problem for hospital-based radiologists, and as more patients enroll in high-deductible plans, the problem will get worse, according to Levin and colleagues.
"Because the price listings from hospitals are generally far higher than those from private outpatient imaging facilities, hospitals will find themselves at a competitive disadvantage and could well lose substantial amounts of their outpatient imaging business to private facilities," they warned.
"It behooves hospitals and their radiologists to provide accurate information to [patients with high deductible plans] who call to inquire about the costs of imaging examinations, particularly advanced imaging examinations," they added.
