Huge discrepancy in prices for the same medical service raises eyebrows

A new study by a national health care group raised serious questions about medical prices charged by physicians and hospitals.  According to the study, patients can pay as much as 683% more for the same medical procedure, such as a MRI or CT scan, in the same town depending on which medical facility they choose.

Some patients pay a percentage of their medical expenses, instead of a co-pay, and they may spend hundreds of dollars more for a certain procedure than if they went some where else in the same town.  The study compared medical prices for the same test or procedure within a 20 mile radius.

The health care group, "Change: healthcare", looked at claims data from May, 2010 to May, 2011 for 82,000 employees of small businesses to determine price differences for MRIs, CT scans, ultrasounds and PET scans.  For a pelvic CT scan, one person paid $230 for the procedure and just a few miles away another paid $1,800.  The cost of a brain MRI in the town ranged from $1,540 to $3,500.

The worst part is that patients rarely are informed about the cost of a procedure until after it has been performed.  Hence, there is no basis for patients to compare medical costs from one medical facility to the next.  The patient only learns the real cost of the medical procedure when he/she gets the bill in the mail.

The authors of the study found a possible $30 billion in cost savings over the one-year study, and even one health plan could save $500,000.  The author of the study gave the following advice to patients: "It's important to ask questions.  Don't assume that the provider you're going to is the best economic deal." Boy, that's an understatement.

Lesson for the day: If you are responsible for paying a portion of  your medical expenses, i.e., a large deductible where you pay a certain percentage of a medical expense, shop around first before selecting a medical provider.  There can be huge differences in the prices charged by medical facilities and doctors for the same medical procedure or test.

If you have any questions or just want to chat, I welcome your phone call on my toll-free cell at 1-866-889-6882 or you can send me an e-mail at jfisher@mmolaw.net.