Patients pay 12% of secondary imaging costs out of pocket

By AuntMinnie.com staff writers

July 23, 2021 -- Patients pay 12% of the costs of secondary imaging interpretation out of pocket, according to a study published July 19 in the Journal of the American College of Radiology.

Researchers led by Sean Doyle, PhD, from the Emory University School of Medicine in Atlanta found that in dollars, the 12% of overall costs borne by patients for secondary interpretations averaged $15.

Secondary interpretations are increasingly performed for patients with complex conditions, but liabilities for patients and paid out-of-pocket costs were not previously known. The team based their study on 7,740 secondary interpretations for adult patients performed over a two-year period in a health system that has 600,000 patient encounters annually across over 400 facilities.

Out-of-pocket costs are generally higher in the first quarter of the year (17%) when patient deductibles and out-of-pocket maximums are less likely to be reached compared to the fourth quarter of the year (9%), researchers found.

They also found that out-of-pocket costs borne by patients are higher in the outpatient setting (13%) compared to the emergency department or inpatient settings (1%-4%). Researchers said this is consistent with the greater likelihood of patients reaching deductible and out-of-pocket limits when hospitalized or in the emergency department compared to when they receive outpatient care.

Study authors said the unexpected bills highlight a need for enhanced physician-patient communication and shared decision-making regarding both the costs and benefits of secondary interpretations.


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