by Adrienne Snavely
The health needs of a community vary by market. If you cannot find what you need or afford it, you should have the opportunity and information to go elsewhere without being penalized.
A patient in Chicago went for a routine blood test, at their doctor’s request, at a hospital. They received a bill of nearly $700, plus $119 for the office visit. Since the lab was hospital-based, insurance did not cover it, and the patient ended up paying just under $500. The patient was unaware other options were available. For example, a lab company called Theranos operates 22 locations in California and Arizona. Its website lists transparent lab prices and the potential savings are significant. Even the uninsured can get a better deal paying out of pocket, since Theranos gives the same price for all, regardless of insurance. Another less expensive option would be to have your primary care physician draw the labs in the office, rather than a hospital.
A blood cholesterol test in California can range from $10 to $10,000, 1000 times that. A basic metabolic panel can range from $35 to over $7000. A complete blood cell count and thyroid hormone assay also vary widely. There is no rational way to explain these price differences. A majority of patients pay discounted rates as negotiated by their insurance plans. Uninsured patients and those looking for care outside of their network will be charged the full amount. Costs are also shifted onto those with insurance to cover those on Medicaid.
How long will patients continue to put up with such outrageous price difference? You can save hundreds, or even thousands, of dollars by simply using a different site of care. As more facilities and physicians provide price transparency, hospitals and other health systems must develop a plan to respond to the competition. The current health care system has an irrational way of charging and payment. It can be explained no other way. Patients can, however, play a role in keeping health care costs down by being “smart shoppers”, getting procedure prices in advance and comparison shopping.
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Dunn, Lindsey. “Maybe healthcare shouldn’t be local.” The Daily Beat Blog. Becker’s Hospital Review, 4 Sep 2014. Web. 14 Sep 2014.
Rabin, Roni Caryn. “Wide Variation In Hospital Charges For Blood Tests Called ‘Irrational’”. Capsules. Kaiser Health News, 15 Aug 2014. Web. 14 Sep 2014.